WASHINGTON, D.C. (March 24, 2023) — Dialysis Patient Citizens (DPC) today celebrates Governor Glenn Youngkin’s (R) signing of Virginia bills SB 1409 and HB 1640 into law, guaranteeing access to affordable Medigap coverage for thousands of Virginians under 65 living with end-stage renal disease (ESRD).

Each of these bills, which contain identical language and were passed with nearly unanimous support in both the Virginia Senate and House of Delegates, were spearheaded by House Majority Leader Terry Kilgore (R-1) and Senator George Barker (D-39). These pieces of legislation come with no fiscal impact to the Commonwealth, and are only estimated to have a $2 monthly premium increase for the overall pool of Virginians with Medigap coverage.

“Today makes an important milestone for every dialysis patient across Virginia,” said House Majority Leader Kilgore. “I want to thank my fellow bill patron Senator Barker as well as every member of both legislative chambers who helped to make this a reality. Moving forward, no dialysis patient in the Commonwealth will have to worry about paying unaffordable rates for the treatments that keep them alive. Having this coverage is essential for ESRD patients seeking a transplant, and passing this legislation means more patients will be eligible for one.”

“For too long, Virginians with kidney disease have been forced to bear an impossibly large financial burden to receive essential medical care,” said Senator Barker. “I am immensely proud of the entire Virginia legislature for doing the right thing and ensuring that every ESRD patient, no matter their age, can affordably access the treatments and medications they need.”

“We thank bill patrons Leader Kilgore and Senator Barker for their work to provide Virginians living with ESRD a level of financial security and peace of mind they have not had previously,” said DPC Board President Andrew Conkling. “Up until now, ESRD patients under 65 in the Commonwealth were faced with the impossible decision of spending down assets to qualify for Medicaid or paying enormous out-of-pocket costs to cover for the cost of dialysis treatments. For many people, that meant deciding between receiving lifesaving treatment, paying rent, or putting food on the table. Thanks to this immense bipartisan accomplishment, that will no longer be the case and more patients across Virginia will become eligible for transplants.”


  • While all patients with ESRD qualify for Medicare, it only covers the cost of 80 percent of the cost of care. The previous law in Virginia did not guarantee ESRD patients under 65 with access to supplemental “Medigap” coverage to pay the remaining 20 percent.
  • This forced patients to either pay that cost out of pocket – upwards of $18,000 annually for dialysis patients – or turn to expensive Medigap plans costing up to 300 percent more than those available to ESRD patients 65 and older. According to Medicare.gov, premiums for Medigap plans previously available to Virginia ESRD patients under 65 cost $6,460 per year compared to $1,615 per year for those 65 and older. Further, some patients make the decision to spend down their assets to qualify for the Virginia Medicaid program, as Medicaid pays the 20% out-of-pocket costs.
  • Most transplant centers will not list ESRD patients on the active kidney transplant waitlist without secondary insurance coverage.


Read the press release on PR Newswire