State Representatives Jamie Callender and Bride Rose Sweeney recently presented sponsor testimony for House Bill 24 (HB 24) before the House Insurance Committee. This bill seeks to extend Medigap coverage to Ohio residents under 65 diagnosed with End Stage Renal Disease (ESRD) and Amyotrophic Lateral Sclerosis (ALS). While these patients are federally eligible for Medicare Part B, they currently cannot purchase Medigap coverage in Ohio.
The state has approximately 1,772 ESRD patients and 410 ALS patients under the age of 65 who would qualify for this expanded coverage. These individuals face significant out-of-pocket expenses due to their conditions, which are not covered by Medicaid. The ALS Association estimates costs of $90,000 per year for ALS care, while ESRD treatment can cost up to $500 per dialysis session.
Lindsay Jack from the ALS Association emphasized the importance of HB 24: “No one diagnosed with ALS before age 65 should face extra financial burdens simply because of their age… This is not only the fair thing to do—it also makes economic sense by helping families avoid financial ruin and reducing reliance on Medicaid.”
Elizabeth Lively from Dialysis Patient Citizens highlighted potential savings: “This bill will help prevent 1 in 4 of the 1,772 Ohioans with ESRD from spending down their hard-earned assets or declaring bankruptcy… It is estimated that passing this legislation will save the Ohio Medicaid program $3.2 million over five years.”
Nationally, about 12% of Medicare enrollees qualify due to long-term disability rather than age. Seventeen states have adopted similar legislation. An analysis predicts that expanding Medigap coverage in Ohio would result in a modest premium increase.
Representative Callender stated, “Every year, hundreds of families here in Ohio receive the crushing news that their loved one has been diagnosed with a terminal disease… friend and family will be able to focus on the things that matter.”
Sweeney added, “No one should have to bankrupt their family to pay for basic medical care after receiving a terminal diagnosis… this legislation takes a balanced approach that fills in gaps.”
The bill now awaits further testimony from proponents within the committee.
