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Oregon legislators table House Bill 4114, ensuring kidney patients have access to treatment

Patients, social justice groups, hospitals and medical providers breathed were able to breathe a sigh of relief this month after lawmakers tabled Oregon House Bill 4114, protecting access to dialysis treatment for Oregonians with kidney failure.

The Northwest Kidney Council, Aimed Alliance, Kaleidoscope Fight Lupus, NAACP Portland and Oregon Medical Association were among organizations opposed to the bill.

Advanced by the health insurance lobby and a union during the state’s short legislative session, the bill would have allowed insurers to fix the rate of reimbursement for dialysis treatment at the Medicare rate, regardless of a patient’s health plan. Kidney patients are among the most vulnerable patient populations, and this unprecedented proposal posed serious consequences for the patient care network and the dialysis ecosystem that was carefully constructed by Congress.

In 1972, Congress created an entitlement within the Medicare program that allowed all patients with end-stage renal disease (ESRD), known as kidney failure, to receive coverage regardless of their age. At the same time, Congress instituted cost-sharing measures that only require the insurance industry to cover this patient population for a maximum of 30 months on commercial insurance. As a result, nearly 90 percent of patients are enrolled in Medicare.

However, Medicare reimbursement rates are below the actual cost of care. This means the remaining 10 percent of patients on commercial health insurance essentially subsidize the cost of care for the vast majority of the kidney patient population, who are on Medicare.

The simple truth is Medicare doesn’t pay the bills. If the Oregon bill had passed, it could have led to clinic closures and cuts to staff, employee benefits and educational and prevention programming. Patients would have suffered from decreased access to lifesaving dialysis treatment, longer trips to travel for care and fewer resources than have been historically provided at dialysis clinics


The Northwest Kidney Council is a regional nonprofit organization that advocates for increased access to care, funding for research and collaboration that improves health outcomes and the quality of life for patients in Oregon and Washington. We commend Oregonians for speaking out on this important issue. Join our mailing list for updates on policies that impact the kidney community.


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