Some Kidney patient groups have sent the Department of Health and Human Services comments regarding
a Dec. 16, bulletin that outlines how essential health benefits are defined and is intended to help states implement the Affordable Care Act. The department said it plans to give states the flexibility to select a benchmark plan that reflects the scope of services offered by a "typical employer plan." This approach, the department said, allows states to select a plan that would best meet the needs of their citizens.

States would choose one of the following benchmark health insurance plans:
•    One of the three largest small group plans in the state by enrollment;
•    One of the three largest state employee health plans by enrollment;
•    One of the three largest federal employee health plan options by enrollment;
•    The largest HMO plan offered in the state’s commercial market by enrollment.  

Kidney patient group comments

The Home Dialyzors United, formerly NxtStageUsers, expressed concern that its members will lose their preferred method of treatment because many of the benchmark plans have policies that state the type of portable dialysis machine many members use is considered experimental and investigational, although approved by the U.S. Food and Drug Administration. The group also recommended that the Medicare  ESRD program be redefined as a renal rehabilitation program

The Renal Support Network recommended that the Medicare Secondary Payer provisions also apply to exchange plans so patients can continue with the insurance they have and not be forced to Medicare primary status sooner than they do today. "This public private partnership should continue as it also reduces the burden on Medicare," RSN wrote.