COLUMBUS, Ohio — The Ohio House Insurance Committee heard proponent testimony on HB 24, a bill to expand Medigap coverage to patients under 65 with Amyotrophic lateral sclerosis (ALS) and end-stage renal disease (ESRD), on Tuesday afternoon.
A rare diagnosis
The hearing included testimony from Strongsville resident Angelina Fanous, who was diagnosed with ALS at just 29 years old.
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"It would drastically improve my quality of life if I could enroll in a Medigap plan," she told News 5 during an interview. "I obviously have a limited amount of energy and time. I should be able to spend my time enjoying life and not fighting with an insurance company."
Right now, Fanous has to switch health insurance plans every year because companies change what they cover and fight denials for basic services, like her feeding formula, which is her main source of nutrition.
What health insurers say
The Ohio Association of Health Plans and America's Health Insurance Plans (AHIP), which lobbies on behalf of health insurance companies, opposes the bill.
During a committee hearing for an earlier version of the legislation last fall, Keith Lake, AHIP, Regional Director, State Affairs, said adding patients under 65 to Medigap policies will increase premium cost for seniors.
"Shifting the expense of this expensive population onto seniors with Medigap policies would add a significant burden to this group, many of whom have been paying for this coverage for many years in order to preserve financial peace of mind," Lake said.
An ALS Association spokesperson said when Indiana expanded Medigap coverage to patients with ALS and ESRD, premiums for seniors only went up by about $1 per month.
At the same time, ALS patients under 65 experienced significant drops in their monthly premiums, the spokesperson said.
The insurance gap
Patients under 65 who are diagnosed with ALS and kidney failure are eligible for Medicare, according to federal law.
To help cover out-of-pocket costs that are not covered by Medicare, Ohio requires private health insurance companies to offer supplemental policies, known as Medicare Supplement Insurance or Medigap policies, to senior citizens.
However, Ohio does not require health insurers to offer Medigap policies to Medicare patients who are under 65.
OH Rep Bride Rose Sweeney (D-Westlake) and OH Rep. Jamie Callender (R-Concord) reintroduced their bill (HB 24 ) torequire health insurers to offer Medigap policies to Medicare patients under 65 last month.
"It can truly make the difference for individuals in Ohio, who are faced with some of the worst things any of us could even imagine," Rep. Sweeney said during the Ohio House Insurance Committee hearing where it was reintroduced.
Their bill would make Ohio the 18th state to require insurers to offer Medigap plans to patients with ALS and ESRD.
There are currently 17 states, including Kentucky, Virginia, and Pennsylvania, that require insurers to offer Medigap plans to Medicare-eligible patients who are under 65.
