Bush proposal would shift ESRD costs to employers

WASHINGTON--More than $1 billion in health care bills incurred by individuals with kidney disease would be shifted to employer-sponsored health care plans from Medicare if Congress passes a cost-shifting provision in the Bush administration's proposed 2008 budget package.

The proposal--identical to one the administration advanced last year but which Congress did not act on--would double to 60 months the period of time that employers, not Medicare, are the primary payers of medical bills for those with end-stage renal disease, an impairment of the kidneys.

In 1972, Congress expanded the Medicare program to provide coverage for ESRD for individuals under 65, the normal eligibility age for Medicare. Legislation later was passed so that employer plans become the primary payer of medical bills for those with ESRD for an 18-month period. In 1997, the law was revamped to extend that period to 30 months.

The proposal to make employer plans the primary payer for 60 months would reduce Medicare expenditures by just over $1 billion between 2008 and 2012, the Bush administration estimates, and boost employer costs by at least that amount.