Author Topic: HR 5615 Prosthetic Parity Bill - meeting w/ your Congressmen and Senators  (Read 2039 times)

Offline Mitchee

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I would recommend that everyone attend a town hall meeting when your Congressmen and Senators have them.

This morning I drove to a neighboring community to attend a town hall meeting that my Congressman was having.  I had the opportunity to speak directly to Congressman Tom Petri about HR 5615 and ask him to vote in favor of it.  He was receptive to my statements and I left some literature (fact sheets) that I had printed from the ACA's website.  I also gave him a copy of HR 5615.  Hopefullly he will vote in favor of prosthetic parity. 

I believe we can all make a difference by visiting with our representatives in person.  Meeting in person puts a face with issue you are asking them to support.  Please meet with your Congressman and Senators when they are in your area.

Initial injury:  July 1985
Amputation:  December 2006 - Ertl LBKA

"The journey of a thousand miles must begin with a single step."
 -Lao Tzu

Offline JClark

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I think this is the same bill a group of us just went to Washington to support.  The ACA organized the day, we showed up with our group, they had meetings setup in advance.  Although most of the ones I went to we met an aide, not the actual senator.  But I think it was still worthwhile.  I think there were 150 amputees wandering around DC that day, all from slightly different locations, so we hit quite a few different offices.

Jason
North-East Pennsylvania
+Left foot------------+Right foot---------------+
|Accident 8/31/2002 |ankle fusion 1/8/2008  |
|Amp 7/11/2003      | RBK (Ertl)    4/7/2010 |
|Ertl June 2005        |                                  |
+---------------------+-------------------------+

Offline Mitchee

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Hi Jason.  Yes, it is the same bill.  Unfortunately, I couldn't go to Washington D.C. but I thought it was important to for me to meet with my congressman when he was back in Wisconsin.

Michelle
Initial injury:  July 1985
Amputation:  December 2006 - Ertl LBKA

"The journey of a thousand miles must begin with a single step."
 -Lao Tzu

Offline pegleg jack

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Lets hope and pray that the lobbest dont get to them and have them shoot it down, the insurance companies dont want it, they want to drop DM coverage all to geather and make us pay for our legs our self, my new CPO told me that if it dosnt pass it will but a lot of leg makers out of business, cause most of us can not afford to pay the price of new legs,
you-all have a great day.

Offline Dick Stevens

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How true!   Here in PA, in the 2007-08 session, the Insurance Industry managed to squelch the Porsthetic Parity Bill.  It went from the Insurance Committee to a quasi-official "Cost Containment" Committee -- and from there into the black hole of oblivion, where it died when the legislative term ended.  (Never made it to a floor vote.)

Gotta remember that when psuh-comes-to-shove, the Insurance Companies aren't in the healthcare business, they are in the business of making maximum profits.   :(
Dick Stevens, DBKA in PA

Offline pegleg jack

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Dick, anit that the truth, started to become a insurance agent and because of my background i couldnt get a liecence, but man they make the bucks off of us thats for sure, i got 60% of the first years preimum and then 20% after that when they renewed. Wont go into what  CEO makes everyyear.
you-all have a great day.

Danny Y

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People,

DO NOT GET TOO EXCITED ABOUT PROSTHETIC PARITY BILLS!!
I live in Massachusetts. A P.P. bill was passed here at the time I lost my leg in 2006. Being a new amputee, I had no knowledge of new legislation until my prosthetist brought it up  when fitting me for my temporary foot. It seems our group coverage only covered $3000/year. That's roughly the cost of the temp leg. He was excited for me because the new legislation in Massachusetts was to  take effect on January 1, 2007. All prosthetic devices and accessories were mandated by state law to be reimbursed at not less than Medicare coverage.
This would mean not less than eighty percent.

WRONG!!

It turns out that there's a federal statute called E.R.I.S.A. which supersedes any state laws. One provision in E.R.I.S.A. exempts health plans which are SELF FUNDED from most state mandates. This included the new prosthetic parity bill. ( For those not familiar with this type of health coverage, it basically works like this......A company or corporation will deduct and/or contribute to a health care fund for their employees' health care coverage. If, at the end of the year, the payout for medical expenses is less than the premiums paid in, the company may save a lot of money. Most companies will hire an insurance company to administer the health plan. They also will pay a premium to cover catastrophic illnesses and injuries which may exceed the premiums collected during the year.

Guess what? Fifty-five percent of all private health coverage in our state is self funded!
My wife worked for a large non-profit hospital. When I lost my leg, she took a one day a week job to help supplement our income. It turned out that both companies used the exact same insurance company for health care. The hospital plan was Self-Funded while the smaller agency was not. Small company had to abide by the new law, big company did not. My wife quit working for the hospital and took a full time position with the other agency. We have full prosthetic coverage now, but only because my wife was willing to change jobs for the insurance. ( Many folks aren't fortunate enough to even have that option.)

So I guess the point I want folks to be aware of is to read the fine print and research the loopholes when supporting legislation. Any improvement for health coverage is good, but it may not be equal for all just because it sounds like it is.

Danny

Offline JClark

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Just goes to show you that the ones with the money (insurance companies) can always find a way to keep it.

I keep having people tell me "what do you mean? Aetna is a GREAT insurance company!"  But they have a different policy with Aetna than the Aetna policy I have....
North-East Pennsylvania
+Left foot------------+Right foot---------------+
|Accident 8/31/2002 |ankle fusion 1/8/2008  |
|Amp 7/11/2003      | RBK (Ertl)    4/7/2010 |
|Ertl June 2005        |                                  |
+---------------------+-------------------------+

Offline Mitchee

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Health insurance companies are always looking for loopholes.  They are always trying to find new ways around paying for claims.  They don't want to have to pay for anything so if they can find a way around it, they will use it.  Health insurance companies are in the business of making profits not providing health benefits.

Wisconsin doesn't have any parity legislation and if we did I'm sure that ERISA would supersede it as well.  The easiest way to prevent federal laws from superseding state laws is to make changes at the federal level.  Write or meet with your congressmen and senators. 

If we as amputees don't make a big deal about parity, the health insurance companies will continue to screw us. 
Initial injury:  July 1985
Amputation:  December 2006 - Ertl LBKA

"The journey of a thousand miles must begin with a single step."
 -Lao Tzu