Progress Toward National Parity
July 2009 Issue
United States Representative Robert E. Andrews (D-NJ) has introduced the Prosthetic and Custom Orthotic Parity Act of 2009 to the U.S. House of Representatives. The bill, H.R. 2575, bans employers and insurers from imposing stricter limits on coverage for prosthetic arms and legs and custom orthotics than those set for other essential medical care.
The bipartisan legislation was introduced May 21 and was co-sponsored by representatives Lincoln Diaz-Balart (R-FL), Al Green (D-TX), George Miller (D-CA), Todd Russell Platts (R-PA), and Joe Sestak (D-PA).
"At a time when healthcare costs are rising by about 7 percent annually, the financial hardship on those in need of prosthetic devices is devastating," Andrews said. "Yet, by expanding coverage for prosthetic devices so that it is on par with other types of essential care, not only will amputees receive necessary treatment and experience better quality of life, but the healthcare industry as a whole will save money. Since prosthetics often dramatically decrease secondary health problems for those in need, the benefits of this coverage far outweigh the costs in the long run."
Andrews also urged his colleagues to support H.R. 2575, saying that it will help end the inequity many Americans who have lost a limb or who live with cerebral palsy experience when their insurance company denies them coverage. H.R. 2575 will remove lifetime caps and exemptions that insurance companies often place on prosthetic and orthotic care, which reduce benefits to such a level that the average person can't afford a prosthesis or complex bracing device. In some cases, these companies even eliminate coverage completely for artificial limbs.
"Such limits are unrealistic," said Kendra Calhoun, president and CEO of the ACA, "since an adult amputee will need a replacement prosthesis every five years and children even more frequently as they grow. It is absurd to expect amputees to use only one prosthesis in their lifetime. No one would expect a person to wear a single pair of shoes their entire life, and prosthetic devices should be no different. People pay their monthly health insurance premiums and expect their coverage to take care of catastrophic situations. Arms and legs are not luxuries."