Thanks to Bostonians’ generosity, victims of the Marathon bombing will avoid the immense financial burden often faced by amputees. As of Thursday, the One Fund Boston had raised more than $28 million. For the bombing survivors who lost arms or legs, that should mean the best care, physical therapy, and prosthetics.
But there are 500 amputations in the United States every day, and for many of those patients, coverage of prosthetic limbs is woefully inadequate. A limb can cost more than $50,000, but only a minority of states, including Massachusetts, require health insurance plans to cover the devices. In states with no such law, some policies cap payouts for prosthetics at $2,500. Though limbs can wear out in as little as three years, some insurance policies also have a “one limb per lifetime” policy.
Mandating coverage doesn’t mean every patient will get one of the cutting-edge, high-tech limbs like those of Paralympic athletes. The law in Massachusetts, for example, requires insurers to cover only “medically necessary prosthetic devices that adequately meet the medical needs of enrollees.”
Advocates for amputees have been lobbying other states to pass mandatory-coverage laws like the one in Massachusetts, and the implementation of the Affordable Care Act could lead to better coverage if the federal government insists that states include prosthetics as an essential benefit. But federal legislation to extend protections nationally has stalled.
The legislation has enjoyed bipartisan support in the House of Representatives, but in the Senate it lost its Republican sponsor when Olympia Snowe of Maine retired. Massachusetts has witnessed, in recent weeks, the trauma of amputation and the ordeal of recovery. The legislation needs a GOP sponsor to take Snowe’s place, and one should step up. If not, GOP Senate nominee Gabriel Gomez should pledge that he’d take up the cause.