Meaningful Health Insurance Coverage for Prosthetic Care Being Advanced in Congress by the ACA

In the face of drastically reduced health insurance coverage for prosthetic care, the Amputee Coalition of America (ACA) has been working with increasing success to advance state legislation requiring health insurance companies to cover prosthetic care on par with other essential medical care. Now, with ten states having prosthetic parity laws in place and a further 29 working towards that goal the time has come to tackle an even bigger challenge, federal legislation. A bill creating the Prosthetic Parity Act, HR 5615, was introduced in the U.S. House of Representatives in March.

The bill was authored by Representative Robert Andrews (D-NJ), with representatives George Miller (D-CA), Todd Platts (R-PA), Mario Diaz-Balart (R-FL) and Lincoln Diaz-Balart (R-FL) signing on as original cosponsors. Rep. Andrews chairs the Health, Employment, Labor, and Pensions Subcommittee and Rep. Miller chairs the Education & Labor Committee while also serving on the Natural Resources Committee.

To raise awareness about the need, create excitement about the effort, and to build support for federal legislation, the ACA organized a “National Week of Action,” from Saturday, April 26 through Friday, May 2. With the help of excited, committed supporters, we coordinated community events, campus events and facility events. Participants held postcard drives, bake sales, lobby meetings and call-in days.

We’ve increasingly seen health insurers drastically limit coverage for prosthetic care by imposing unrealistically low dollar caps and restrictions, even limiting coverage to one prosthesis per lifetime. A solution to this problem is federal legislation requiring health insurers to provide meaningful coverage for prosthetic care and eliminate any distinctions between prosthetic care and other essential medical care covered by their policies.

This is the same type of legislation that the ACA has been championing in state legislatures with such success. Indiana recently became the ninth state to pass a prosthetic coverage law.

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, productive lifestyle, supporting their families and contributing to society, rather than being dependant on it.

It is truly sad that a health insurance plan, whose ever-increasing premiums have been paid for years by individuals and their employers, forces its members to rely on community fundraising, bake sales and other sources of charity to pay for prosthetic care for themselves or their children or other family members. Unfortunately, we hear about this all too often.

The ACA has taken the lead and serves as the standard-bearer for the campaign for both state and federal legislation requiring meaningful insurance coverage for prosthetic care.