BREAKING NEWS! Governor Rell vetoes prosthetic parity bill. Take action today!!

We are sad to say that Governor Rell recently vetoed HB 5021, which included coverage for prosthetic devices. The governor vetoed several other bills including a bill related to health and nutritional information in restaurants and a green jobs bill. We still have a chance. If the governor vetoes a bill when the legislative session is over, the legislators come back for a three-day veto session about two weeks after the governor's last action. That means we need to act fast.

TAKE ACTION TODAY! Click here for contact information, a sample phone script and sample e-mail.

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TAKE ACTION: Urge your members of Congress to protect amputees' needs in healthcare reform legislation!

The health reform battle is ramping up. It is imperative that we work hard to push for the needs of amputees. We need your help to tell members of Congress where we stand on health care.

The ACA is joining a coalition of disability rights group in calling for national call-in days. Next week we urge you to call your members of Congress and tell them not to DELAY! Our message --- we need strong comprehensive health reform that helps ALL Americans, including people with limb loss!

TAKE ACTION! On July 7th and 8th, callers can use the following toll-free number: 1-866-210-3678 to contact their representatives and senators.

We must work together to make comprehensive, high quality health care for all a reality. Help us flood the switchboards at the Capitol on July 7th and 8th. Urge your members and coalitions to call in using 1-866-210-3678.

When you call the toll free number, you will ask to speak with your representative. (if you do not know who represents you, click here)

Please, also call your senators' offices! (click here to find out who represents you in the Senate)

Any healthcare reform proposal that truly gets at improving health systems and enhancing access must address the specific needs of people with limb loss!

Talking Points
• True healthcare reform must include specific language providing access to assistive devices such as wheelchairs, prosthetics and orthotics!

• Congress must address the two-year waiting period for Medicare disability benefits.

• Adequacy of coverage is critically important. Please, oppose any that would preempt or roll-back state benefit laws.

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ACA ADVOCACY UPDATE, Week of June 8th

From the States
▪ In the final hours of their session, CT passed parity into law. The language was inserted into another health benefit bill. It is now awaiting the governor’s signature. If she takes no action it becomes law after 15 days.

Overview of the State Campaigns
▪ There are now a total of 18 states with parity laws in place (CO, ME, NH, RI, CA, MA, OR, NJ, IN, VT, LA, AR, IA, MD, TX, MO and CT).

▪ Bills are now being advanced in PA, WI, IL, MI, NY, NC, AL, MN, NE, ND, UT, AZ, OH, ID, NC, GA, KS, KY, TN and WA.

▪ We are also working with ME to get the microprocessor exemption taken out of their existing parity law.

ON THE HILL --- Parity
▪ As you know, the House re-introduced the federal parity bill on May 21st (HR 2575). We have been working to identify additional co-sponsors.

▪ We have been meeting with members of the House Education & Labor, Ways & Means and Energy & Commerce committees to bring on new co-sponsors and cultivate support around healthcare reform.

▪ Our two issues for reform have been the inclusion of assistive devices in the minimum standards and the inclusion of people with disabilities in the health disparities. This gives additional attention to the particular needs and concerns of people with limb loss in terms of research, provision of care, care standards and coordination of services.

▪ We are working with Senators Snowe and Harkin to re-introduce the Senate version. We were in touch with Lee Perselay and Jenelle Krishnamoorthy from Snowe’s office this week regarding the need to get the bill re-introduced ASAP in order to keep up the momentum not only for the stand alone, but more importantly the healthcare reform provisions.

HEALTH CARE REFORM

▪ Chairman Edward M. Kennedy and Democratic Members and staff of the Senate Committee on Health, Education, Labor and Pensions (HELP) released the “Affordable Health Choices Act” on Tuesday.

Click here for a copy of the bill, http://help.senate.gov/BAI09A84_xml.pdf.

Some highlights from the bill include:

• Prohibits pre-existing condition exclusions

• Prohibits discrimination based on health status, including disability

• No lifetime or annual limits

• Requirement of a single risk pool

• Rehabilitative services referenced

• Community living assistance services and supports referenced

▪ There are a number of health reform timelines and bill summaries in circulation. Thought it would be helpful to meld them together in summary form. You will find a summary of likely House and Senate timelines for health reform legislation below.

House Timeline

End of Week of June 15 - Draft bill language is released. This bill will be referred to three committees- Energy and Commerce; Education and Labor; and Ways and Means

Week of June 22 - Hearings in the 3 committees (possibly at subcommittee level)
Week of June 29 – Recess; negotiations continue
Week of July 6 – Full committee hearings
Week of July 13 – Full committee markups
Week of July 27 - House floor consideration

Senate HELP Timeline

Week of June 8th – Committee walkthroughs and hearing/roundtable(s)Week of June 15th – Series of markups of different components of legislation
Week of June 22nd – Additional markups

Senate Finance Timeline

Week of June 8th - Ongoing bi-partisan member meetings.Week of June 15th - Committee mark released
Week of June 22nd – Committee markup over several days


Senate Floor Timeline

Week of July 20th – Beginning of consideration on Senate floor
Week of July 27th – Completion of Senate consideration

As you know, we are part of the Consortium for Citizens with Disabilities (CCD). CCD will have a presence and testify at the hearing. We will continue to communicate with relevant offices. We are also working to generate grassroots level contact with the offices around healthcare reform (http://www.amputee-coalition.org/armsandlegsarenotaluxury/index.html).

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Healthcare Disparities & People with Limb Loss

The ACA recently sent comments to the Senate HELP Committee staff, Chairman Kennedy and Ranking Member Sen. Enzi on the topic of health disparities and people with limb loss. The ACA is urging Senate leaders to ensure that health care reform will eliminate the disability-based health disparities faced by the more than 54 million Americans with disabilities, including the almost two million people with limb loss. Research shows that individuals with disabilities experience a lower rate of education, and employment, and a higher rater of poverty when compared to non-disabled persons. The Agency for Healthcare Research and Quality (AHRQ) reports that private health insurance is less available to people with disabilities. Two Surgeon Generals’ reports have called attention to the need to address disability-based health disparities in access to clinical care, prevention and wellness, and public health services. The main cause of acquired limb loss is poor circulation in a limb due to arterial disease, with more than half of all amputations occurring among people with diabetes mellitus. Today, diabetes is much more common in African Americans, Hispanic/Latino Americans, and American Indians/Alaska Natives. It is estimated that more than 75 percent of the amputations caused by diabetes complications might be prevented. Proper testing and treatment must be available in order to prevent both primary and secondary amputation.

Non-white, low-income patients without commercial insurance are more likely to delay diagnosis of peripheral vascular disease (PVD), which often results in amputation of the lower limbs. In spite of the startling evidence of the disability-based health disparities and the inherent costs to treat preventable conditions, current federal law does not consider individuals with disabilities a “medically underserved population” and fails to recognize disability-based health disparities under any federal program that addresses other health disparities. Health reform must fix this injustice.

Click here to read the ACA's letter to Chairman Kennedy, Sen. Enzi and the HELP staff.

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Healthcare Reform & People with Limb Loss

The ACA submitted comments regarding the Senate Finance Committee’s set of recommendations regarding policy options for health care coverage contained in the document Expanding Health Care Coverage: Proposals to Provide Affordable Coverage to All Americans. In summary, the ACA is supportive of the recommendations regarding individual and small group market reform. These improvements to the private health insurance market will have significant positive implications on the ability of all Americans to access affordable health insurance regardless of their health status. We also strongly support the recommendations regarding Medicaid, including recommendations that serve to eliminate the two year waiting period for disability coverage and inclusion of disability status as a category for purposes of measuring health disparities.

The ACA is deeply concerned, however, with the limited scope of the benefit package that would be available under the Health Insurance Exchange. Based on the document released by the Committee, there is a complete absence of any benefits related to rehabilitation therapies and related services (in both the inpatient and outpatient settings) as well as durable medical equipment, orthotics, prosthetics (DMEPOS) and other assistive devices.

Click here to read the ACA’s comments to the Expanding Health Care Coverage: Proposals to Provide Affordable Coverage to All Americans proposal.

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ACA ADVOCACY UPDATE, Week of May 25th

From the States

▪ Bills passed in 6 states during the 2009 session (IA, VA, MD, AR, TX and MO).

▪Bills are still in play in 6 states (PA, WI, IL, MI, NY, NC).
ü MI: Referred to the Health Policy committee. Awaiting action. Legislature meets throughout the year.
ü IL Passed out of the House. Passed out of the Senate committee. The insurance lobby is pushing hard for caps. Legislature meets throughout the year.
ü PA: Referred to the Health and Human Services committee. Awaiting action. Legislature meets throughout the year.
ü WI: Introduced 4/27. Legislature meets throughout the year.
ü NY: Referred to the insurance committee. Trying to work with sponsor to coordinate a day in Albany to jump start the efforts. Legislature meets throughout the year.
ü NC: Still discussing including language in another bill. They adjourn in July.

▪ The sessions in adjourned in 6 states without passing parity into law (AL, CT, MN, NE, ND, UT).

ü AL: Never moved out of committee. The legislature adjourned May 15th.
ü CT: We worked to revise the language several times. Action was not taken before they adjourned.
ü MN: Introduced 5/11. The legislature has adjourned until Feb 4, 2010/
ü NE: Died in committee.
ü ND: Passed the Senate. Died in the House.
ü UT: Passed in the House. Died before being voted on in Senate.

▪ We are working to organize meetings and calls to pull together a plan of action in each of these states building towards re-introduction in 2010. We are also working on identifying and cultivating local coalition partners.

▪ We are working to get legislation introduced in 2010 in 7 states (AZ, OH, ID, NC, GA, KS, KY).

▪ The ME bill to remove the microprocessor exemption from the existing parity law was carried over for the 2010 special session. Morgan traveled to Augusta on May 26th to meet with local leaders and activists to start the planning process.

▪ Two bills are currently being studied (TN and WA).
ü TN: Tabled for study over the summer and debate in the 2010 session.
ü WA: A study bill was introduced. We are waiting for the analysis.

ON THE HILL --- Parity
▪ The House re-introduced the federal parity bill last week (HR 2575). Authored by Rep. Rob Andrews (D-NJ), sponsors include Representatives George Miller (D-CA), Lincoln Diaz-Balart (R-FL), Todd Platts (R-PA), Joe Sestak (D-PA), and Al Green (D-TX).

▪ We are meeting with targeted members of the Ways & Means, House Education & Labor and Energy & Commerce committees to secure additional co-sponsors and push for inclusion of assistive devices within healthcare reform.

▪ We are also reaching out to past sponsors to push for them to sign on to the 111th version.

▪ We are continuing our in-district push. We developed a kit and materials for the Memorial Recess.

▪ We are continuing to work with Senator Snowe’s office to get the bill introduced in the Senate. The ACA is in a meeting on Friday, May 29th with her staff.

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ACA ADVOCACY UPDATE, Week of May 4th

From the States
▪ The Maryland bill was signed into law by Gov. O’Malley on Thursday.

▪ Texas and Virginia are still awaiting the Governor's signature.

▪ The Pennsylvania parity bill was referred to the Health & Human Services Committee. We are waiting for a hearing to be scheduled.

▪ Bills are still in play in WI, CT, MO and IL.

The Wisconsin bill was introduced on April 27th.

Illinois passed favorably out of the Senate committee. This was seen as the biggest hurdle because several of the members of the committee expressed concerns with the legislation. The next step is the Senate floor.

Connecticut has been an up hill battle every step of the way. The first version had a cap. We got it removed. Then, we had a bill with a microprocessor exemption. Thanks in part to all of the calls and emails made by our activists and strong, consistent direct lobbying that has been removed. The current version will allow for access to microprocessor devices as long at they are determined to be medically necessary. We are of course working to ensure that the prosthetist and/or physician be the one(s) to determine medical necessity, not the insurance companies. The twist is that current version only provides coverage for children under 18. We have been working with the sponsor and other allies to push for a full vote on a comprehensive bill. Our activists in CT, including all of Hanger’s clinics have been very actively pushing at the grassroots level. We may not win, but we will have a voting record. We have to think of this in terms of a long-term strategy.

Though the Missouri bill passed out of both the House and Senate committees, it is not going to receive a floor vote as a stand alone bill. They are working to get it passed as an amendment to another vehicle. It has been attached to a few different bills. It is now a bit of a waiting game, though they are continuing to work behind the scenes to pass one of the bills with the parity amendment. We have been coordinating with our intern and activists to get calls and emails into offices in a final push. They adjourn next week, so this is it!

▪ The TN, AL, NE, NY, ME, ND, and MI bills appear to be stuck. We will work with our activists there to strengthen our efforts for 2010. Many of these states will also be targets for our summer organizing meetings.

The Tennessee bill has been referred for a cost study. This is similar to what transpired in several others states (NE, MD, NJ, VA, etc). It will be considered next year after the study has been completed.

No recent action in AL, NE, NY and MI. Many of these states will be targeted for our summer organizing meetings in order to build and enhance our efforts for the 2010 session.

ME will come up in the special session. We have scheduled a meeting for May 26th with local leaders to coordinate our activities. This week, we confirmed several participants to join the core group working on this initiative.

▪ Four states are still working to introduce a bill this year (OH, ID, NC and MN).

In Idaho, Minnesota, North Carolina and Ohio bill language has been finalized. They have sponsors confirmed for next year. They may have the opportunity to introduce it this year.

▪ Two sessions already adjourned for the year without passing legislation (UT and ND).

ON THE HILL --- Parity
▪ Currently, our lead House folks are working to confirm our sponsors from the past, particularly the House Republicans. We coordinated with Rep. Diaz-Balart’s office to create a one pager to be used in the Republican outreach.

▪ We are reaching out to all of our lobby day participants to get them to double back to each of the offices they met with to confirm/identify co-sponsors prior to introduction.

▪ We are continuing our in-district push.

▪ We are also reaching out to past sponsors to push for them to sign on to the 111th version.

▪ We are still working with our partners to coordinate with Snowe’s office to get the Senate version finalized and introduced.

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ACA ADVOCACY UPDATE, Week of April 27th

From the States
▪ Texas passed the Senate and is awaiting action from the governor. Upon receiving a bill, the governor has 10 days in which to sign the bill, veto it, or allow it to become law without a signature. The bill covers prosthetic and orthotic devices.

▪ Maryland and Virginia are still awaiting the Governor's signature. Governor O’Malley is scheduled to sign a slew of bills on May 17th and 21st. No word yet from Governor Kaine’s office, though we have had a positive response.

▪ The Pennsylvania parity bill was referred to the Health & Human Services Committee. We are waiting for a hearing to be scheduled.

▪ Bills are still in play in WI, CT, MO, TN, and IL.

The Wisconsin bill was introduced on April 27th.

Illinois passed out of the House. A hearing was scheduled for May 6th.

A bill tied to Medicare passed through the Connecticut Insurance Committee (18-1) and Appropriations (48-2), BUT it includes an exemption for microprocessors. This has been a complicated process. The bill started with a $2,500 cap, which we were successful in getting removed. We are trying to get this taken out. We have been in touch with the committee members and leadership. We have local activists and practitioners conducting outreach. We are also working with Otto Bock on getting an official letter in opposition with background/educational information. We have come further this year than any other year, but we want to make sure that the right policy is enacted to provide real access to amputees in Connecticut.

Missouri passed out of both the House and Senate committees, so we are awaiting floor action in both chambers.

The Tennessee bill has been referred to a study committee. The analysis should be completed in the fall in anticipation for the 2010 session.

▪ The AL, NE, NY, ME, ND, and MI bills appear to be stuck. We will work with our activists there to strengthen our efforts for 2010. Many of these states will also be targets for our summer organizing meetings.

The ND bill passed the Senate. It was killed in the House. They are trying to get the language included in other legislation.
NE is pushing to get a committee vote.
ME will come up in the special session. We have scheduled a meeting for May 16th with local leaders to coordinate our activities.
No real action in AL, NY and MI.

▪ Four states are still working to introduce a bill this year (OH, ID, NC and MN).

In Idaho, Minnesota, North Carolina and Ohio bill language has been finalized. They have sponsors confirmed for next year. They may have the opportunity to introduce it this year.

▪ One session has already adjourned for the year without passing legislation (UT).

ON THE HILL
▪ Rep. Andrews has committed to re-introducing the orthotic and prosthetic parity legislation. A timeline of the next 1-2 weeks was mentioned. We are also looking to confirm a meeting with Snowe’s office to finalize the Senate language.

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Texas parity bill PASSED!!!

We just heard. We oo not have the vote count yet. The bill is now on its way to the governor's desk. The committee has been reaching out to his office. We have had a positive response, so we feel confident.

That is 5 bills passed already this year (VA, MD, AR, IA, TX) with a couple more looking possible!!

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