Prop. 23 would require on-site doctors, prohibit insurance discrimination for dialysis clinics

Dialysis Machine
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Proposition 23, which will be voted on in November, aims to regulate dialysis providers and protect patients from discrimination based on insurance.

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The controversial Proposition 23, which will be on the November ballot, aims to protect dialysis patients by increasing regulations on dialysis clinics, although those who oppose it say the proposition would cause clinics to close due to higher costs.

Prop. 23 would require the roughly 600 dialysis providers in California to have an on-site physician, report data to the state and federal government on dialysis-related infections, get the state health department’s consent before closing a clinic and not discriminate against patients based on their insurance.

Kidney dialysis is a process in which blood is removed from patients’ bodies, cleaned of toxins, then returned to the patient. Approximately 80,000 patients across California must receive dialysis treatment three times a week.

According to Steve Trossman, spokesperson for Service Employees International Union-United Healthcare Workers West, or SEIU-UHW, Prop. 23 is one of a series of measures sponsored by the union that is aimed at regulating dialysis providers and protecting patients.

In 2018 and 2019, dialysis corporations spent more than $100 million in lobbying efforts against legislation that would increase regulations on dialysis clinics, such as Prop. 23, according to the proposition text.

Trossman added that dialysis corporations have annual profits of billions of dollars nationwide, including $350 million per year in California alone.

“Dialysis is a dangerous procedure — people have had heart attacks because of it, people get infections,” Trossman said. “This initiative says to the dialysis companies, use some of the millions of dollars you make in California to make sure these clinics have a doctor or a nurse practitioner on-site.”

Trossman added that the union believes Prop. 23 will improve health care in California by helping dialysis patients safely access lifesaving care and reducing health care premiums in the state. Currently, Trossman said dialysis clinics drive up health care costs by charging high premiums for patients with private insurance, but the proposition would require clinics to charge the same for patients regardless of the source of their payments.

In contrast, No Prop 23, a coalition formed in opposition to the proposition, said Prop. 23 would drive up health care premiums by increasing costs for dialysis clinics. Nearly 100 groups, including the California Medical Association, patient advocacy groups, veteran groups and dialysis providers oppose the proposition, according to No Prop 23 spokesperson Kathy Fairbanks.

“Prop 23 would unnecessarily increase health care costs and make the doctor shortage worse for all Californians by moving thousands of practicing doctors into non-caregiving roles in dialysis clinics,” said Peter Bretan, president of the California Medical Association, in a No Prop 23 press release.

Fairbanks added that the No Prop 23 coalition believes the proposition would endanger dialysis patients’ lives by forcing dialysis clinics to cut services and close. In contrast, Trossman said he thinks dialysis corporations would still make large profits and would not be in danger of closing down.

SEIU-UHW has raised about $6 million in support of the proposition as of press time, and the two leading dialysis corporations have raised about $2 million in opposition.

Contact Alexandra Feldman at [email protected] and follow her on Twitter at @a_p_feldman.