Proposition 8: Authorizes State Regulation of Kidney Dialysis Clinics. Limits Charges for Patient Care. Initiative Statute.   Recommendation: SUPPORT

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Over 66,000 California residents receive dialysis treatments for kidney failure.  Dialysis removes the blood impurities the kidneys no longer can filter, and access to regular dialysis care is essential.  Missing even one appointment may create complications that can result in organ failure, even death. Most long-term treatment is done on a three-times weekly basis with the bulk of services provided through two for-profit companies. 
 
These two firms have profits five times higher than cost of service charged by an average hospital. Those with private insurance are charged as much as $150,000 per year which is a 350% charge over the actual costs.  The Affordable Care Act (ACA) once regulated the percentages that could be charged but with those federal controls now largely removed, dialysis has become a particular cost burden.  Private insurance, Medicare, Medicaid, and those without insurance at all are carrying the financial load.
 
This proposition requires dialysis charges be restricted to 115% of direct patient care costs, requires repayments to those overcharged whether private insurance providers or individuals, requires regular reporting on costs, charges, and revenues. Most important, it forbids discrimination against patients based on the source of their payment for care.
 
As we struggle with finding ways to keep health care both affordable and accessible, this proposition tackles both issues. The reimbursement level is consistent with the standards set by the ACA that worked for both providers and those paying the bills.It is a reasonable solution to a growing crisis of unaffordable health care including for essential life-saving options. 

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