On Monday, the governor of Washington state signed the first So EveryBODY Can Move law of 2025, requiring insurers to cover orthotic and prosthetic devices (including prosthetics for recreation, showering, and other activities) that are deemed medically necessary by a patient’s doctor. That brings the total of states that have passed SEBCM legislation to nine. Three additional states (Georgia, New Jersey, and Oregon) have passed SEBCM bills through one chamber of their respective legislatures and are likely to close the deal during this year’s session; seven other states have SEBCM bills at various points in the lawmaking pipeline. Check our Bill Tracker to see where things stand in your state.
Like the eight previous states that have passed SEBCM, Washington enacted its law with overwhelming bipartisan support. It’s another sign that national lawmakers are getting the message about the budgetary benefits of O&P insurance reform. It’s a simple principle: Better orthotic and prosthetic care leads to healthier patients, and healthier patients lead to lower healthcare expenditures. You spend a little extra on the front end, but you save a bundle in the long run.
Shaneis Malouff and Jeffrey Cain produced one of the first systematic analyses of this equation in 2023, and it helped convince budget-conscious legislators in Illinois and Colorado to support SEBCM and get those bills across the finish line. Their 2024 study crunched numbers for 11 states, including three that passed SEBCM last year (Maryland, New Hampshire, and Minnesota) and two that are close to passing it this year (New Jersey and Oregon). Malouff and Cain are back with a new analysis that examines the cost savings of prosthetic insurance in 14 states, including Washington (which enacted the law) and Georgia (which is about to). Their work has real-world impact.
As Congress deliberates on sharp reductions in federal healthcare spending, states are more motivated than ever to find cost savings. And SEBCM bills are about as close to free money as you can get. In exchange for negligible premium increases on consumers—literally pennies per month—these bills unlock potential cost savings ranging from tens to hundreds of millions of dollars.
Let’s use Washington state, the latest inductee into the SEBCM club, as an example. We’ve simplified the math here; if you want to get down into the weeds of the methodology, refer to the 2024 paper. Per Malouff and Cain’s estimates, Washington’s O&P patient population under the age of 65 (ie, not covered by Medicare) totals 111,412 people. Insuring medically necessary O&P devices for all of those patients would increase state healthcare spending by roughly $10 million. That cost increase, spread among Washington’s 6 million private insurance customers, would raise premiums by about $1.50 a year per person, or 13 cents a month. (That’s a median projection; the actual cost could be as low as 1 cent a month or as high as 47 cents, per Malouff and Cain’s calculations.)
The $10 million up-front cost would promote mobility, exercise, and overall health among Washington’s O&P patients, thereby reducing their need for costly healthcare related to heart disorders, vascular disease, neuropathy, mental health, obesity, chronic pain, and so forth. The average patient’s healthcare spending needs would drop by about $2,500 per year. Multiply that figure by the state’s 111,412-patient O&P population, and you end up with some $278 million in reduced spending—a 2,800 percent return on the $10 million investment.
A no-brainer, right? Washington’s lawmakers certainly thought so, approving the measure by an aggregate vote of 121-25. The House vote was even more lopsided (171-2) in Georgia, which can net $371 million in healthcare savings according to Malouff and Cain’s estimate. Georgia’s bill has been parked in the Senate Insurance and Labor Committee for more than a month; the session still has a long way to go, so the chances of eventual passage remain pretty good.
New Jersey (which passed its SEBCM bill unanimously through the full Senate and two House committees) stands to reap $331 million; Oregon (which garnered unanimous support in the Senate) is looking at a $150 million windfall. Lawmakers in Florida and Texas could reduce their states’ spending by $715 million and $1 billion, respectively, via SEBCM, but neither state has a pending bill at this point.
The new paper is titled “Assessing the Net Positive Social and Fiscal Impact of Preventive Care: A Policy Review of Prosthetic & Orthotic Commercial Insurance Coverage.” It has not been published yet, but we’ll add a link to the published study when that’s available.
