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Kelly, colleagues introduce Restore Protections for Dialysis Patients Act
March 24, 2025
WASHINGTON, D.C. -- Today, U.S. Rep. Mike Kelly (R-PA), along with Reps. Yvette Clarke (D-NY), Neal Dunn, M.D. (R-FL), Danny Davis (D-IL), John Joyce, M.D. (R-PA), and Raul Ruiz (D-CA) announced the reintroduction of the Restore Protections for Dialysis Patients Act, bipartisan legislation which aims to ensure that individuals with End Stage Renal Disease (ESRD) continue to have equitable access to private healthcare and to provide protection of the Medicare Trust Fund.
The legislation follows a 2022 Supreme Court ruling that has allowed private health plans to prematurely force ESRD patients onto Medicare, creating disruption in coverage for patients and their families and shifting a significant financial burden onto taxpayers.
"This legislation is critical for Americans living with End Stage Renal Disease and who rely on dialysis," said Rep. Kelly. "Patients deserve to know their benefits will be in place when they need them. This legislation will improve both patient care and patient outcomes. I want to thank my House colleagues for joining me on this vital legislation."
"The tens of millions of Americans across our nation today who are fighting kidney disease should not face the danger of a disruption in coverage due to reasons beyond their control. It’s clear these individuals – who disproportionately belong to communities of color – are relying on Congress to stand up for them and protect their equitable access to necessary healthcare. I’m proud to support this bipartisan solution to ensure every American on dialysis has the care they need to live the lives they deserve," said Congresswoman Clarke.
“ESRD patients should not be concerned that they will be forced off their health insurance plan while seeking lifesaving dialysis treatments,” said Congressman Dunn. “I am proud to support this legislation to ensure that patients who depend on dialysis can focus on their treatment without worrying about their health insurance coverage.”
"The hundreds of thousands of patients throughout the country who rely on regular dialysis treatments should never be in fear of losing their access to care," said Rep. Joyce, M.D. "The Restore Protections for Dialysis Patients Act would ensure that patients with End Stage Renal Disease have access to the treatments they need."
“I thank members of Congress for introducing the Restore Protections for Dialysis Patients Act, which will ensure insurance plans provide life-sustaining care to dialysis patients,” said LaVarne Burton, President & CEO of the American Kidney Fund (AKF). “This critical legislation will ensure that the Medicare Secondary Payer Act (MSPA) is working for the benefit of those it was intended to protect.”
“MSPA effectively protected patients with the option to stay on their private insurance plan as they navigated their life-altering diagnosis of kidney failure, but we’ve unfortunately seen that protection upended,” said Mahesh Krishnan, MD, MPH, MBA, Chair of Kidney Care Partners. “Now, we encourage all lawmakers to work together to restore critical protections for patients with kidney failure by passing the Restore Protections for Dialysis Patients Act without delay.”
Rep. Kelly first introduced this legislation in December 2023.
You can read the bill text here.
BACKGROUND
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In 1981, Congress amended the Medicare Secondary Payer Act (MSPA) to add language to protect against private health insurers from designing benefit plans to push individuals with ESRD onto Medicare prematurely.
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For decades, health plans have abided by the principles of MSPA, benefitting both beneficiaries and taxpayers.
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In June 2022, the Supreme Court ruled that health plans can effectively push ESRD patients onto Medicare, prompting a need for Congress to introduce legislation to clarify the Medicare Secondary Payer Act and protect ESRD patients from being kicked off of their private health plans.
Issues:Health Care
Mike Kelly: The RESTORE Act supports dialysis patients and strengthens Medicare | Opinion
September 19, 2025
This summer, we received some startling news about the long-term financial health of Medicare — the trust fund that pays Medicare's hospital bills would be depleted in 2033, three years earlier than expected. Nearly 1-in-5 Americans already depend on Medicare, and millions more soon will. Solving Medicare's looming fiscal crisis is a must.
It's equally important that we do not worsen Medicare's financial situation. But, following the Supreme Court's 2022 Marietta ruling, that is exactly what is beginning to happen.
The ruling forces employers to make tough decisions regarding their employees and may prematurely force patients living with end-stage renal disease onto Medicare, creating disruption in coverage for patients and their families and shifting a significant financial burden onto taxpayers. My legislation, the bipartisan Restore Protection for Dialysis Patients Act (RESTORE Act), aims to ensure that individuals with end-stage renal disease (ESRD) continue to have equitable access to private health care and to provide protection of the Medicare trust fund.
This legislation is critical for Americans living with end-stage renal disease and for those who rely on dialysis. Patients deserve to know their benefits will be in place when they need them. Our goal is simple: to improve both patient care and patient outcomes.
End-stage renal disease, also known as kidney failure, impacts more than 27,400 Pennsylvanians, according to the Dialysis Patient Citizens Education Center. More than 80% of dialysis treatments are covered by Medicare, their data shows.
When patients lose their private health insurance plan and are forced onto Medicare, the government doesn't simply pick up the tab for their dialysis treatments; it's on the hook for all their health care needs. That adds up to billions of dollars now onto the backs of all American taxpayers. Medicare, which provides health insurance coverage to more than 67 million Americans, is already on shaky ground. This ruling and its ripple effects further add fuel to the fire."
That's why the RESTORE Act is a game changer. My legislation isn't simply about fixing bad policy. It's about building a sustainable future for a program Americans have paid into their entire lives.
Medicare currently spends about $51 billion a year on costs associated with dialysis patients, according to a 2022 American Kidney Fund report. "To offset some of those costs to taxpayers, Congress passed (the Medicare Secondary Payer Act) to give patients 30 months to transition to Medicare as their primary insurance; private health insurance is secondary," the report notes.
The RESTORE Act would bring back the protections that Americans had before Marietta, letting patients stay on their private insurance instead of being forced onto Medicare. It would ensure that the Medicare Secondary Payer Act is working for the benefit of those it was intended to protect. Plus, it would allow dialysis clinics to remain open, save taxpayers billions, and make sure people receive the care they need without breaking the bank.
Congress put these safeguards in place decades ago for a reason, and it's time to bring that commonsense policy back. The RESTORE Act strengthens Medicare's future, it saves taxpayer money, and it allows Pennsylvanians — and Americans at large — to continue receiving the care they need without delay.
U.S. Rep. Mike Kelly, of Butler, is a Republican representing Pennsylvania's 16th Congressional District. He serves on the Ways & Means Health Subcommittee and is the lead sponsor of the Restore Protection for Dialysis Patients Act (RESTORE Act).
Commentary: SC dialysis patients need Sen. Tim Scott's support
October 17, 2025
When it comes to people going through kidney failure, South Carolina is full of stories of people stepping up for their neighbors and loved ones.
Earlier this year, the law enforcement community and other organizations around North Charleston rallied together to support a police officer battling kidney disease. More recently, nonprofits and organ donors gathered in Clemson for a triathlon to raise funds and register new donors. Here in South Carolina, we look out for each other. But people with kidney failure need more help from Congress.
Today, thousands of South Carolinians living with end-stage renal disease are counting on U.S. Sen. Tim Scott, R-S.C., to champion legislation that could mean the difference between financial stability and medical bankruptcy.
End-stage renal disease, commonly known as kidney failure, represents a growing health crisis in South Carolina. Unlike many chronic conditions, there is no cure — only management through dialysis or kidney transplant. Unfortunately, transplants are rare, leaving the vast majority of patients dependent on dialysis treatments three to four times per week for the rest of their lives.
Historically, newly diagnosed patients could maintain their employer-provided insurance as primary coverage for the first 30 months, providing continuity of care and financial relief during the most vulnerable period of their treatment. This grace period allowed patients to maintain access to their established physicians, preferred medications and comprehensive care networks while they planned for the inevitable transition to Medicare.
However, a U.S. Supreme Court ruling enabled private insurance plans to discriminate against dialysis patients by cutting coverage and reducing reimbursement rates for life-sustaining treatments. This forces vulnerable patients off their private insurance plans and into Medicare far earlier than intended, creating both medical and financial hardships at the worst possible time — when they're already struggling to adapt to a life dependent on dialysis.
This creates significant problems. While Medicare covers 80% of dialysis costs, patients must find ways to cover the remaining 20% — a burden that can amount to thousands of dollars monthly. Many patients are forced to spend down their life savings to qualify for Medicaid, a process that devastates families financially while shifting costs to taxpayers, which is hardly a conservative outcome.
The medical consequences are equally severe. Private insurance typically provides better access to physicians, medications and treatments compared to Medicare. Most critically, private insurance gives dialysis patients a significantly better chance at receiving a life-saving kidney transplant.
The solution is straightforward: Sen. Scott should cosponsor the Restore Protections for Dialysis Patients Act (S.1173), bipartisan legislation that would protect access to private insurance for people with kidney failure. Sen. Scott’s influence on the Senate Finance Committee, which is considering the bill, could be the difference that gets this vital legislation to President Donald Trump’s desk.
This legislation already enjoys bipartisan support from senators across the political spectrum, from Republican Bill Cassidy of Louisiana to Democrat Martin Heinrich of New Mexico. The bill doesn't create new government programs or expand federal spending: It simply restores a protection that existed for decades until the Supreme Court's 2022 ruling created uncertainty.
For South Carolina's dialysis patients, this isn't about politics — it's about survival with dignity. These are working South Carolinians who paid into insurance plans with the reasonable expectation that their coverage would be there when they needed it most. They're asking not for handouts, but for the protection they were promised.
Sen. Scott has built his reputation on standing up for S.C. families and defending access to high-quality health care. Supporting the Restore Protections for Dialysis Patients Act offers him a clear opportunity to demonstrate these values while helping thousands of vulnerable constituents navigate one of the most challenging health crises imaginable.
South Carolina's dialysis patients deserve better than bureaucratic games that treat them as liabilities. They deserve the stability, dignity and quality care that only comes with protected access to their private insurance coverage. Sen. Scott should stand with them by cosponsoring the Restore Protections for Dialysis Patients Act.
Dr. Zachary W. Sutton teaches at MUSC as an adjunct faculty member and is a health care researcher and a co-founder and executive director of the S.C. Transplant Fund, a charity that assists transplant recipients.
The Post and Courier: https://www.postandcourier.com/opinion/commentary/dialysis-patients-private-insurance-tim-scott-congress/article_0cb027f0-aa85-4b91-9baa-f9b9057ba955.html