On September 19, 2008, the U.S. Senate introduced the “Prosthetics Parity Act of 2008,” a bi-partisan-supported bill that would ensure that those covered by employer-based health insurance have access to prosthetic care. The legislation is co-sponsored by Senator Olympia Snowe (R-ME), Senator Tom Harkin (D-IA), Senator Daniel Inouye (D-HI) and Senator Russell Feingold (D-WI).
Prosthetics Insurance Coverage
“The legislation which we are introducing today – the Prosthetics Parity Act of 2008 – will ensure that group health plans treat coverage of such prosthetics on par with other essential medical care covered by health insurance,” said Senator Snowe. The bill’s introduction means that both houses of Congress are now considering legislation that would benefit amputees. In March, “the Prosthetic Parity Act” (HR 5615)—which would require health insurance companies to provide benefits for prosthetics on par with other medical care—was introduced into the House of Representatives.
ACA Support
Both pieces of legislation are strongly supported by the Amputee Coalition of America (ACA), a national non-profit organization that advocates for and empowers those with limb loss. According to President and CEO Kendra Calhoun, prosthetic care benefits offered by insurance companies are often too low to obtain a prosthetic; and when insurance companies do provide a prosthetic, they often limit beneficiaries to one per lifetime.
According to Calhoun, adult amputees will need an average of one replacement every five years, while children need replacements even more frequently. Data from the ACA also shows that health insurance parity laws are relatively inexpensive and would only increase the price of premiums by approximately 25 cents. According to Calhoun, “Parity legislation would save the federal government and taxpayer’s money by preventing cost shifting for prosthetic care from the health insurance companies to government programs such as Medicare and Medicaid.”
Other States Behind Prosthetic Parity
Several state legislatures are currently working on prosthetic parity issues. Eleven states have passed prosthetic parity laws, while an additional 30 are advancing legislation at this time. On a yearly basis, approximately 155,000 people in America experience limb loss. Recent statistics show that almost two million Americans are currently living with amputations in the United States and 700,000 of them are under the age of 18.
“Sadly, we see those children particularly affected as their growth increases the frequency with which a prosthetic requires replacement,” said Senator Snowe. “That can quickly exceed a parent’s ability to meet co-payment requirements – a coverage cap may deny access to a replacement prosthetic,” she added.
Since its introduction, the House bill has generated a total of 25 co-sponsors and advocates are hopeful that the Senate bill will generate a similar outpouring of bi-partisan support.
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For more information, see Amputee Coalition of America Petitions to Eliminate the Two-Year Waiting Period for Disability Medicare Benefitsfor amputees.
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