Statement from Jesse Roach, MD, Senior Vice President, National Kidney Foundation
On Senate Passage of the “One Big Beautiful Bill”
Washington, DC – (July 1, 2025) “The so-called ‘Big Beautiful Bill’ that passed the Senate today is a giant leap backward for people living with kidney disease. It’s deeply disappointing that the Senate took an already problematic bill from the House and made it worse. The Senate’s version accelerates devastating Medicaid cuts, imposes new burdensome barriers to care, and threatens the health and lives of kidney patients.
Nearly 300,000 dialysis patients in the United States rely on Medicaid. Yet this bill imposes an 80-hour monthly work requirement, introduces new copays, and slashes key funding streams for rural hospitals and dialysis clinics. These changes could leave millions without coverage—undermining early detection, disrupting life-sustaining treatment, and forcing patients into an already overburdened emergency-only care center.
Some of the most concerning provisions include:
- Work Requirements: New mandates would apply to parents of teenagers and others with chronic health needs, including kidney disease—putting them at risk of losing coverage before qualifying for Medicare.
- Provider Tax Cuts: The bill reduces allowable Medicaid provider taxes from 6% to 3.5% by 2031, limiting critical funding for dialysis clinics, particularly in rural areas.
- New Copays: A $35-per-treatment copay for dialysis and CKD patients above the poverty line could cost dialysis patients over $5,000 annually.
- ACA Enrollment Barriers: The bill would eliminate automatic reenrollment and increase paperwork burdens, potentially delaying coverage for over 700,000 individuals by 2034.
- Inadequate Rural Health Funding: While it includes a $15 billion rural stabilization fund, this falls far short of what’s needed to keep dialysis clinics and hospitals open in underserved areas.
These changes may save money on paper, but in reality, they will result in poorer outcomes, increased suffering, and higher long-term costs to the taxpayers and the healthcare system. The National Kidney Foundation urges Congress to reject these harmful provisions and instead advance policies that support sustainable, equitable kidney care.”
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Media Contact:
Paul McGee
716.523.6874
paul.mcgee@kidney.org