Amputee Advocates Build Data Arsenal for Policy Battles

Most of us don’t have the bandwidth to do the hard work of legislative reform, even for causes we care about—such as fair insurance laws that enable more amputees to gain access to prosthetic devices. But we probably can find a few minutes to support the brave souls who are down there in the political trenches, slugging it out for better policies to serve the limb-loss community.

If you can spare those few minutes, here’s how to use them for maximum effect.

First, complete the online So Every Body Can Move survey on physical activity (and, as a bonus, get qualified for an Amazon gift card raffle). Then urge your prosthetist to complete the Fiscal Impact L-Code Survey before it closes on October 27.

Both surveys will provide frontline advocates with the data they need to push successfully for fair insurance laws. They’re backed by the same coalition of limb-loss organizations that scored overwhelming legislative victories for amputees in four states earlier this year. The group expects similar bills to be introduced in roughly ten states in 2024—and this, in turn, could be a prelude to a push for federal legislation that broadens access to prosthetic devices nationwide.

Your survey response can help most or all of these bills get enacted into law. Not a bad payoff for a few minutes of your time.

Read on for details about what data will be collected in these surveys, and how hard numbers can persuade skeptical legislators to drop their opposition to fair insurance bills. And please help spread the word—shout this out via your social media channels, amputee support groups, etc., and encourage others to participate.

So Every Body Can Move Fiscal Impact L-Code Survey

Who can take it: Prosthetists and orthotists

Who’s leading the study: Shaneis Malouff, chief analyst at Upstream Informatics, on behalf of AOPA

Why the survey is necessary: Any legislative reform is easier to sell if you can show it will save the government money. That’s exactly what happened in Illinois this year, where Malouff’s fiscal and social impact analysis provided a decisive boost to a stalled bill. Her peer-reviewed study concluded that prosthetic insurance reform would only increase premiums by a few pennies per month, while substantially reducing state expenditures for healthcare and social services. She backed up those findings with hard numbers from three states (Colorado, Illinois, and Connecticut), paired with Medicare data.

The L-Code study will strengthen Malouff’s analysis in two ways: by expanding it to a broader cross-section of states, and by integrating more specific, state-by-state insurance-claims data. These more granular numbers will yield a sharper picture and give legislators might further reduce the already-low cost estimates of fair prosthetic insurance.

Straight from the source: “This survey data will give us a second methodology. The first cost estimate was based on data from one state’s All-Payer Claims Database (APCD). But APCD data is difficult to obtain, so the L-Code survey will give us a second [cost] estimate based on data from boots on the groundthe clinicians in each state. With this data, we can take it a step further. We’ll find the cost associated with the most common [prosthetic] devices, multiply that by each state’s population, and get a second cost estimate of premiums per-month, per member. That number will be shared with the lead amputee advocates in each state. We’re being as conservative as we can so legislators understand the fiscal benefits [of these bills].” —Shaneis Malouff, chief analyst, Upstream Informatics

Encourage your prosthetist to take the survey before October 27 at Google Docs.

So Every Body Can Move Physical Activity Survey

Who can take it: Anybody with limb loss, limb difference, or limb impairment who lives in the United States

Who’s leading the study: Dr. Susannah Engdahl, manager of health policy and research for the American Orthotics and Prosthetic Association (AOPA)

Why the survey is necessary: A big lesson of the 2023 legislative session is that most legislators are completely ignorant of the obstacles amputees face to staying physically fit, maintaining an active lifestyle, and even (in many cases) getting access to basic prosthetic care. Data from this survey will allow advocates to document the roadblocks, illustrate how they harm amputees, and explain how legislative reform can ensure that amputees receive the same insurance protections as nondisabled Americans.

Straight from the source: “The Affordable Care Act already includes [recreational prosthetic] care as an essential health benefit, but insurance companies haven’t been interpreting them as medically necessary. Our legislation is simply clarifying that these benefits are already medically necessary. . . . . This will be one of the most comprehensive surveys ever taken of individuals about the barriers they have to accessing prosthetic and orthotic care for physical activity. We can use that both in our state-by-state initiative, but also to set the stage for a reform at a national level.” —Nicole ver Kuilen, manager of public engagement for AOPA

Take the survey at aopa.questionpro.com/physical-activity.

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