H.R. 9891 – Prevent ESRD Act
PREVENT KIDNEY FAILURE. INCLUDE VETERANS.
We shouldn't wait until kidney failure to start investing in kidney health.
The PREVENT ESRD Act (H.R. 9891) would create a 10-year federal demonstration program designed to encourage health plans to invest earlier in kidney disease, before patients progress to end-stage renal disease (ESRD).
The bill would expand access to kidney screening, FDA-approved treatments that slow kidney-function decline, nutrition services, patient education, disease-management support, genetic counseling, kidney-health consultations, telehealth and other services designed to preserve kidney function and prevent or delay kidney failure. Participating plans would also be required to provide kidney-disease screening without cost-sharing.
The idea is simple: reward healthcare systems for helping people KEEP their kidney function, not just paying for treatment after kidney failure occurs.
EKF strongly supports that direction.
But we're bringing another voice into this conversation: America's veterans.
1 in 6 Veterans have CKD and Nearly 13,000 Veterans progress to kidney failure every year
Veterans and the VA healthcare system are not specifically identified in the introduced bill. As this legislation moves forward and the federal government develops this prevention model, EKF is asking lawmakers and HHS to make sure veterans are explicitly represented in the conversation.
If America is building a strategy to prevent kidney failure, veterans cannot be an afterthought.
H.R. 9891 - Why we need your support
Too many kidney patients enter the healthcare system after significant kidney damage has already occurred.
Their kidney function declines.
Their disease progresses.
Their options become narrower.
And eventually the conversation becomes dialysis, transplantation and kidney failure.
What if we changed where the system puts its attention?
What if healthcare systems were rewarded for identifying kidney disease earlier, connecting patients to treatment sooner and helping prevent or delay progression to kidney failure?
That's the idea behind H.R. 9891, the PREVENT ESRD Act.
And we're not alone in believing this deserves attention.
The legislation has already earned support from major voices across the kidney community, including the National Kidney Foundation, American Kidney Fund, American Society of Nephrology, NephCure, Renal Physicians Association and others.
That's a big deal and EKF is proud to stand alongside a kidney community pushing prevention further upstream.
The PREVENT ESRD Act would establish a 10-year demonstration program designed to encourage participating health plans to invest in earlier kidney care, with the opportunity to share in Medicare savings when those efforts successfully reduce progression toward ESRD.
So why does EKF care, and why should our FilterLIFE™ family be tracking this bill with us?
Because we're bringing another voice to the conversation: America's veterans.
Veterans can navigate a healthcare environment unlike almost any other patient population, moving between VA Healthcare, Community Care, civilian nephrologists, specialty care, transplant centers and other interconnected systems.
Yet veterans and the VA healthcare system are not specifically identified in the introduced legislation.
That doesn't make this a bad bill. It gives us an opportunity to make a good bill even stronger.
We're not asking Congress to change the mission of H.R. 9891.
We're asking them to make sure veterans are part of it.
If America is going to invest in earlier detection, earlier intervention and preventing kidney failure, veterans deserve to benefit from that progress too.
Whether you're a patient, caregiver, Veteran, healthcare professional or advocate, we're asking you to learn about H.R. 9891, track it with us and help amplify a simple message:
PREVENT KIDNEY FAILURE. INCLUDE VETERANS.
It's Not About Paying for Kidney Failure - It's About Preventing it
What it does: H.R. 9891 would establish a 10-year demonstration program designed to increase access to kidney-care services that can prevent or delay progression to ESRD. Participating plans that successfully reduce kidney-disease progression may become eligible to share in savings created for Medicare.
Why this matters: America's healthcare system spends enormous resources treating kidney failure.
The bill itself cites approximately $126 billion annually in direct healthcare spending related to kidney disease, including more than $50 billion annually in Medicare spending related to ESRD treatment.
The truth: We need to invest earlier.
Screen earlier.
Diagnose earlier.
Treat earlier.
Educate earlier.
And preserve kidney function whenever medically possible.
The goal shouldn't simply be managing kidney failure more efficiently.
The goal should be preventing as many people as possible from reaching it.
It's Not Just Screening - It's Connecting Diagnosis to CARE
What it does: H.R. 9891 requires participating plans to develop strategies for regular kidney-disease screening and includes screening measures such as urine testing, blood-based testing, genetic testing when appropriate and other methods necessary to identify kidney disease.
But the legislation goes further.
Specified kidney-care services may include FDA-approved medications and biologics designed to slow kidney-function decline, nutrition services, patient education, follow-up support, genetic counseling, community health workers, social-needs referrals, kidney-health consultations and medically appropriate telehealth.
Why this matters: Finding kidney disease is only the first step.
A lab result doesn't help somebody if nobody explains it.
A diagnosis doesn't change an outcome if the patient can't access treatment.
A referral doesn't work if the patient gets lost between healthcare systems.
The truth: Screening needs to lead somewhere.
Detection → Diagnosis → Education → Treatment → Follow-up.
That's how prevention becomes real.
It's Not One-Size-Fits-All — Kidney Disease Has a Cause
What it does: H.R. 9891 recognizes that preventing kidney-disease progression can require far more than routine monitoring. The legislation specifically includes access to medications and biologics that slow kidney-function decline, genetic testing and counseling, disease-management support and other kidney-care services.
Why this matters: Kidney disease isn't one disease.
Diabetes and hypertension are major causes of kidney damage but patients can also live with IgA nephropathy, FSGS, membranous nephropathy, C3G and other glomerular, genetic, autoimmune and rare kidney diseases.
Two patients can have the same eGFR and need very different care.
The truth: Preventing kidney failure requires understanding WHY kidney damage is happening—not simply watching the number fall.
Earlier diagnosis and disease-specific treatment can completely change a patient's trajectory.
We shouldn't just monitor kidney decline. We should fight to stop it.
For Veterans, Prevention Must Include the VA
What it does: H.R. 9891 identifies several types of eligible participating plans, including commercial/group health plans, Medicaid programs, Medicaid managed-care plans, Medicare Advantage plans and other plans the Secretary of Health and Human Services may specify.
What we noticed: The introduced legislation does not specifically identify veterans or the Department of Veterans Affairs healthcare system.
And that's where EKF is raising our hand.
Veterans can have unique kidney-health risks and healthcare pathways.
They may navigate:
VA Healthcare.
Community Care.
Civilian nephrology.
Specialty kidney care.
Transplant centers.
Toxic-exposure evaluations.
Multiple medical-record systems.
A national strategy designed to prevent kidney failure should consider how that strategy reaches those patients too.
The truth: EKF isn't opposing this legislation.
We're saying:
YES and include us.
H.R. 9891 even requires HHS to host a kidney-disease listening session involving clinical experts, patients, patient advocates, health plans and innovators, and it requires additional public input and consultation with patient-advocacy organizations while the program is designed.
That's exactly the conversation veterans need to be part of.
Veterans shouldn't have to wait until kidney failure to benefit from a national movement toward earlier screening, earlier treatment and kidney-disease prevention.
If we're building the future of kidney prevention in America, America's veterans belong at the table.