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On Feb. 1, 2018, over 100 people who rely on charitable financial aid to afford their health insurance premiums in Hawaii will be forced to find other ways to pay their bills and maintain their access to the lifesaving medical treatment they need to survive. Salome Tupou is one of 115 patients identified thus far who have received letters from the Hawaii Medical Services Association (HMSA) stating that it will not allow charities to help patients pay their insurance premiums, the Honolulu Star Advertiser reported last week. Tupou’s kidneys are failing, and so she receives dialysis treatment – a process that filters toxins from her blood because her kidneys no longer can – several times each week to live. She doesn’t have a choice of whether to seek this treatment, but she has been grateful for financial aid from the nonprofit American Kidney Fund, which helps her pay for her insurance premiums. “I’m not able to work anymore,” Tupou said, according to the Star Advertiser. “I don’t know how I’m going to pay for my medicine and dialysis. I feel like it’s not fair for HMSA to do this to us because it’s hard for us to find better coverage to take care of us. Without the [American] Kidney [Fund] to help us pay for everything like that, I don’t know where I’m going to turn to pay for my coverage.” Speaking on behalf of insurance companies that have covered these patients, HMSA was dismissive of the concerns of patients like Tupou, who will now have to find coverage through a different, government-sponsored health plan. “So they’re going to be fine,” HMSA spokeswoman Elisa Yadao said. “They will have access to care and very little transition issues.” These words could not be further from the truth. As insurance companies shift the costs for health care onto the state and steer patients onto Medicaid, patients may have to change doctors, and they might have less access to critical surgeries or other medical treatments they need. Dialysis patient Jeffery Wong receives charitable assistance from the American Kidney Fund, which helps pay for his $1,500 monthly insurance policy. “I’m going to lose my doctors,” said Wong. “My medicines would be between $500 to $800 a month. My co-pays for doctors may be to $200 to $400 a month easily. Those are not things I can afford to pay.” Nor should patients have to pay when charitable assistance programs across the nation are willing to help patients like Tupou and Wong at no cost to the public. Hawaii is among 42 states where insurance companies are rejecting patients with chronic diseases in their greatest time of need, and there is no indication that they are stopping there. Congress is considering federal legislation to help protect these patients and ensure insurance companies are required to accept charitable financial aid. Take action and let your representative know that you support people’s right to choose the insurance plan that is best for them and to receive financial aid from charities if they need it. Together we can fight back against insurers who discriminate against people with chronic diseases.