Prosthetic Parity Legislation
What is the Prosthetic Parity Legislation?
It is an initiative from the Amputee Coalition of America [5] to get state legislatures to pass a law that would enforce insurance companies to cover prostheses at the same level of coverage of other medical conditions, or at least at a level comparable to that offered by Medicare.
How would this bill affect the cost and availability of insurance?
Studies in various states have shown that the cost of providing prosthetic coverage would be between 12¢ and 16¢ per member per month. This is to say, less than $2 per member per year. It is clear that health insurance costs would remain within the reach of the average consumer.
How would the legislation affect insurance companies?
Without a prosthesis, amputees might be forced to live a more sedentary lifestyle. This would lead to more serious complications:
vDiabetes à medications can cost up to $100 per month
vHeart attack due to vascular complications à surgical treatment and hospitalization can range from $75 000 to $200 000
vKnee or hip problems à can lead to costs ranging from $80 000 to $150 000
vWrist, elbow and shoulder problems à surgeries range from $7500 to $25 000
Thus, providing prosthetics would prevent more serious conditions, which would represent higher expenditures for insurance companies. Prosthetics parity would actually be economically favorable for everyone.
Has it been successful?
The parity legislation has passed in 9 states (California, Colorado, Indiana, Maine, Massachusetts, New Hampshire, New Jersey, Oregon, and Rhode Island). At this time, 31 additional states are advancing a similar legislation. Furthermore, the U.S. Senate is currently reviewing the Prosthetics Parity Act of 2008 [37].