It was a busy summer for District 16 House of Delegates candidate Hrant Jamgochian.
Jamgochian and wife Lenna had their first child in August. He spent a lot of time knocking on doors, looking for support in his second crack at a District 16 seat.
The 40-year-old Bradley Boulevard resident also had a lot going on at his day job, as executive director of the nonprofit lobbying group Dialysis Patient Citizens.
The Centers for Medicare and Medicaid Services, which oversees the Medicare program, in July proposed a 9.4 percent (or $970 million) funding cut for dialysis treatments. Jamgochian and others in dialysis patient advocate groups say the move would mean service cuts at dialysis clinics and a $24 cut in reimbursement for each treatment from $240 to $216.
That set off a frenzied summer of activity. Jamgochian helped organize a fly-in for kidney failure patients from 49 states to meet with their members of Congress. The efforts have resulted in a bi-partisan group of 205 members of the House sending a letter to the Medicare administrator urging against the cuts.
Jamgochian said the cuts would threaten dialysis clinics nationwide and services such as nocturnal dialysis, which allows patients with jobs to get treatments after typical business hours.
“My passion has always been about patient access, about making sure that everyone has access to affordable high quality healthcare,” Jamgochian said. “Dialysis patients are typically among the most vulnerable members of our society.”
More than 80 percent of dialysis patients are on medicare.
The proposal for funding cuts came as a result of an order in January from Congress. Health and Human Services was directed to eliminate the extra $530 million to $880 million a year in federal payments for dialysis.
In 2011, the government created a single bundled payment for each treatment in order to reduce the number of uses of Epogen, the most common drug used in dialysis. The use of Epogen dropped more than the government expected, resulting in major profits for companies that run dialysis clinics.
In August, a New York Times story suggested lobbyists were pushing to avoid the cuts to protect the profit margins of dialysis companies.
“The most offensive thing about that story is the implication that patients are just conned,” Jamgochian said. “If this was a cut to cancer treatments, there wouldn’t even be a question. Utilization of this one medication has gone down, but for years, the higher payment for the medication has always made up for the lower payment of the overall dialysis treatment.”
The Centers for Medicare and Medicaid Services is expected to make a final ruling on the proposed cuts in early November after reviewing public input.
Access to healthcare is a major part of Jamgochian’s platform for District 16. He previously worked for United Way Worldwide on solving health disparities between demographic groups. In Bethesda and Chevy Chase, his focus is on increased access to home healthcare, an issue for seniors.
“That’s an area I’m passionate about, helping people age in place and reduce overall costs,” Jamgochian said. “In healthcare, there’s only a certain amount of dollars. It’s about figuring out how do you best utilize those resources.”
As a state delegate, Jamgochian said his role would be to help implement the Affordable Care Act so that insurers provide enough doctors and specialists to ensure adequate coverage.
“A lot of it is delegated to the state. Some of those things that don’t get cleared up are going to get pushed to the state level,” Jamgochian said. “I’ve been pushing at the federal level for things like network adequacy. If someone purchases a plan and the insurance is required to cover cancer treatment, we need to make sure they don’t turn around and have only one oncologist available in the state of Maryland.”
Jamgochian has a number of coffees and two fundraisers scheduled for the fall. He’s also talking about Pepco (he testified against rate increases in front of the Public Service Commission), environmental issues and poverty.
He said education has been one of the most talked about issues when he knocks on doors, especially the cost of higher education.
“Even in our district, parents have been telling me they’ve been doing everything right, saving up for 20-plus years for their kids and now they’ve had to tell their kids, ‘Well maybe let’s not apply for that school,’” Jamgochian said. “I think some of that has to do with our economy and the number of highly-skilled, highly-educated individuals who are maybe underemployed in our district.”
Jamgochian finished a close third behind Delegate Ariana Kelly in the 2010 primary after a late entry into the race.
This time around, he hired a full-time campaign manager — an uncommon move in delegate races.
There are five known candidates for three District 16 seats about nine months out from the June 24 primary: Kelly, Jordan Cooper, Marc Korman, Kevin Walling and Jamgochian.
With two delegate seats open, many local political observers are surprised there aren’t more at this point. Some predicted there would be 15 to 20 delegate candidates by primary day.
“The only thing I have control over is what my campaign is doing and what I’m doing,” Jamgochian said. “From my personal perspective, it’s been really exciting and almost humbling — the number of folks who have been coming out to support my candidacy and, most important, the issues we’re talking about.”
Photo via The Patient’s Voice