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Introduced into Congress on March 17, 2008 with bi-partisan support, the Prosthetic Parity Act (HR 5615) would require health insurance companies to provide benefits for prosthetics on par with other medical care.  The legislation seeks to reverse a growing trend among health insurance companies, who have steadily decreased benefits for prosthetics in recent years. 

According to a poll by the Amputee Coalition of America (ACA), approximately one quarter of Americans have experienced a decrease in prosthetic coverage over the last three years.  Additionally, millions of Americans are unaware that they have disproportionally low prosthetic coverage, with some plans capping benefits at as little as $1,200 or eliminating them entirely.

“Thousands of people who face the trauma of limb loss also face additional shock when they discover that their insurance company will not pay for the prosthetic limb that will enable them to return to an active and productive lifestyle,” said Paddy Rossbach, CEO of the ACA, the main advocacy organization behind the legislation. 

The ACA recently launched a coast-to-coast week of action to call attention to the bill.  More than 90 events—such as rallies, lobby meetings, and postcard drives—were held across the country.  Participants also organized bake sales to show how many amputees are forced to rely on demeaning forms of charity to pay for their limbs.

In addition to introducing the federal bill, the ACA has successfully passed ten statewide laws mandating prosthetic parity.  Three have been signed in the last year, including Vermont, which enacted the legislation on April 23 after it was passed unanimously in the State Senate. 

“I don’t want anyone to have to go through the shock and trauma of something like this happening, and then find out they have such limited insurance coverage,” said South Burlington resident Eileen Casey, a cancer victim with an amputation who had been working on behalf of the bill.

According to the ACA, providing equal benefits for prosthetics would only increase insurance premiums by between 12-35 cents, and even that miniscule cost would be compensated for by a decrease in long-term healthcare and an increase in productivity that would accompany better prosthetic coverage.

For the 1.7 million Americans currently living with amputations, and the 185,000 who become new amputees every year, such legislation is a necessity.

“When individuals discover that prosthetic care is not covered by their health insurer, or it is extremely limited, they may have to resort to using retirement funds or children’s college savings to purchase the prosthesis they need,” Rossbach said. “Some individuals in this situation have even taken mortgages out on their homes to get to the prosthesis they need.”