Nobody really opposes the Triple A Study Act, a federal bill intended to document gaps in prosthetic care for American amputees. Introduced in 2020 and re-introduced last year, the bipartisan legislation would authorize the Government Accountability Office (GAO) to examine healthcare costs, access to prosthetic devices, insurance coverage, and overall health outcomes for people with limb loss. The bill has a modest price tag and would almost surely lead to a reduction in government spending over time. It’s supported by Democrats and Republicans, prosthetists and patients, military veterans and limb-loss advocates, and just about everyone else.
The only thing holding up this common-sense bill is political gridlock. Though it commands broad support and offers obvious benefits, the Triple A Study Act is nowhere close to getting passed.
Last month, the bill’s four lead sponsors—two Republicans and two Democrats—took matters into their own hands. Sens. Tammy Duckworth (D) and Marsha Blackburn (R) and Reps. GK Butterfield (D) and Brett Guthrie (R) wrote a letter formally asking the GAO to act on its own authority and investigate the gaps and disparities in access to prosthetic devices. Such a project lies well within the GAO’s discretion; the only difference is that the lawmakers are requesting the report, rather than requiring it legislatively.
Last week, GAO accepted the request, which calls for a final report to be submitted to Congress by July 1, 2023. The legislators asked the GAO to analyze data from Medicare, the Department of Veterans Affairs, and other sources to assess a broad range of factors related to limb loss, including (but not limited to):
* affordability of prosthetic devices and care
* availability of rehab and physical therapy
* pattern of insurance denials
* amputees’ workforce participation
* quality and availability of resources to educate limb-loss patients
* amputees’ overall health indicators, including conditions commonly related to limb loss (such as diabetes, heart and vascular disease, chronic pain, and mental health issues)
“Two million Americans currently live with limb loss or limb difference,” the sponsors wrote in their formal request. “Two-thirds of these Americans will not receive a prosthetic device, and there is a lack of information to explain why such a disparity exists. Healthcare payers such as the Centers of Medicare and Medicaid Services, the Veterans Health Administration, and private insurers will benefit from the additional research into limb loss and limb difference that this [report] would provide. This will be used to inform future legislation.”
Writing in support of the legislators’ request, the Amputee Coalition said: “When only 35 percent of Americans living with limb loss or limb difference receive a prosthetic device, it is incumbent upon us to discover where the barriers to access exist and then remove those barriers to allow Americans to gain the necessary access. This effort displays a commitment in a bipartisan manner from Congressional leaders to fully develop an understanding of the needs impacting the limb loss and limb difference community.”
In a perfect world, the Triple A Study Act would have sailed through the House and Senate. In the world we actually inhabit, this discretionary step will suffice. It’s a clear win for the limb-loss community, and an important step toward better data and broader access to prosthetic care.