The proposed Ohio Constitutional amendment on kidney dialysis is a reckless amendment that will make it harder for 18,000 Ohioans with kidney failure to receive the life-saving treatment they depend on, while doing nothing to lower their dialysis costs. The amendment was written and bankrolled by a California-based special interest group – the SEIU-UHW West Local 2005 – which has no experience in the treatment, management, or regulation of dialysis. The SEIU-UHW and its Ohio affiliates have a long history of using controversial ballot issue campaigns to leverage their political agenda.
The reckless dialysis amendment would place arbitrary revenue limits on community clinics, which would force clinics to cut back, close, or consolidate services to fewer clinics, resulting in reduced access to clinics and increased travel time and expenses for many patients and their families — particularly those in poor, disadvantaged, and rural areas. By reducing access to care, the reckless amendment would hurt Ohio’s 18,000 patients who receive life-sustaining dialysis treatment at the 326 community dialysis clinics across the state. Forcing the state government to set arbitrary rate and rebate schedules would reduce dialysis clinics’ ability to maintain their current level of care or make investments in technology or personnel to improve their quality of care.
The out-of-state special interest group wrote the proposed amendment without any evidence of a problem, and without first trying a normal legislative or rule-making process that would bring knowledgeable stakeholders to the table. If passed, the amendment would be “etched in stone” in the Ohio Constitution. The Governor and Legislature can’t change the Constitution. Changes would require another Constitutional amendment approved by a vote of the people, which is an expensive, time-consuming and cumbersome process that could put dialysis patients’ lives at risk.
Furthermore, Ohio’s community dialysis clinics are already subject to extensive regulation and monitoring by state and federal government agencies; additional requirements in the Ohio Constitution are duplicative and unnecessary. Rules regarding specific medical procedures such as dialysis do not belong in the Ohio Constitution.
The reckless amendment calls for rebates on services, but it does not require the insurance companies, which will receive these rebates, to pass the money on to their customers. Further, this proposed amendment exempts “federal, state, or local government payers such as Medicare and Medicaid” from receiving rebates. Medicare and Medicaid cover an estimated 85% of patients receiving dialysis treatment in Ohio. Private health insurance companies only cover 11% of Ohio dialysis patients, yet they would receive all the rebate money. The remaining 4% of patients are covered by the Veterans Administration and other government payers, which are also exempt from receiving rebates.
Meanwhile, it places artificial limits on the revenue that community dialysis clinics receive for their services and requires clinics to pay rebates to private insurance companies. The amendment arbitrarily defines the amounts that exceed “reasonable charges for dialysis treatments” as “115% of the sum of all direct patient care services costs and all health care quality improvement costs.” The amendment requires the rate and rebate calculations to be made and enforced by the Ohio Department of Health, which has no experience setting rate structures.