As the 115th U.S. Congress considers potential healthcare reform, the American College of Rheumatology (ACR) sent a letter to congressional leaders to ensure that proposals will protect and promote access to health insurance for all Americans living with arthritis and rheumatic diseases.
“More than 52 million people in the U.S. — one in six Americans — live with rheumatic diseases, making it the nation’s leading cause of disability,” Sharad Lakhanpal, MBBS, MD, president of the ACR, said in a press release.
“Early and appropriate treatment for rheumatic diseases like arthritis and lupus, provided by trained rheumatologists, can prevent or slow disease progression, decrease the likelihood of disability, and reduce long-term healthcare costs,” Lakhampal said.
“The ACR looks forward to working with both Congress and the incoming administration to ensure that every American has access to affordable, high-quality healthcare, including care for arthritis and other rheumatic diseases.”
The ACR proposes that all Americans living with these potentially debilitating diseases should be covered by continuous health insurance and have access to a rheumatologist and other rheumatology specialists for consultative and maintenance care.
In its letter, the ACR proposes that health coverage should have no preexisting illness exclusions; that coverage should exist for services valuable to arthritis patients (for example, biological, physical, and occupational therapies); insurance coverage should exist for health educational activities; and patient co-payments should be limited for medications and services.
The ACR also emphasizes that travel is difficult for rheumatic patients, and laboratory, radiological, and infusion services should be available near the patient’s medical care.
They also recommend that healthcare policies should be designed to provide rheumatology patients with early access to care. This is important because rheumatologists provide ongoing care to patients with chronic conditions that are serious to diagnose and treat.
Given the increasing demand for rheumatology care, more experts are needed, the ACA wrote.
“The CDC estimates that one in four Americans will have doctor-diagnosed arthritis by the year 2040,” Lakhanpal said. “With the rates of doctor-diagnosed arthritis on the rise, a thriving rheumatology workforce and affordable access to specialists and treatments will be critical to ensure we meet the care needs of a growing patient population.”
The ACR also stated that any legislative proposals should include these provisions:
- Repeal the Independent Payment Advisory Board (IPAB) under the Affordable Care Act, which has the explicit task of achieving specified savings in Medicare without affecting coverage or quality.
- Lessen the administrative burden through universal prior authorization systems in the case of multistate insurance plans.
- Maintain the FDA’s authority to approve safe, effective biosimilars that can encourage market-based relief from the high costs of biologic arthritis drugs.
The ACR said its ultimate goal is to “ensure every American has access to affordable, high-quality healthcare.”