New acupuncture legislation has been proposed in Massachusetts. The Acupuncture & Oriental Medicine Society of Massachusetts (AOMSM) has proposed a bill that expands acupuncture and oriental medicine health insurance coverage and establishes a commission to study the integration of acupuncture into wellness programs. The bill specifies that all individual and group health insurance policies must provide acupuncture and oriental medicine coverage in Massachusetts for the treatment of pain, PTSD (post-traumatic stress disorder), nausea and substance abuse.
President Barak Obama’s Patient Protection and Affordable Care Act, nicknamed Obamacare, outlines health insurance basic standards. Preventative and wellness care and chronic disease management are mandated as part of those minimal standards for all individual and small group health insurance policies. Now, it is up to the states to decide the specifics. California and Maryland have already included an acupuncture mandate under this provision.
AOMSM notes that Washington state has an acupuncture mandate for all health insurance policies and there has been no significant increased costs to providers associated with the mandate. AOMSM also notes in a recent study of health insurance coverage in New York, “Expenditures on acupuncture may be offset by reductions in other healthcare utilization.” The same study notes that, “Reluctance by insurance companies to cover acupuncture for fear of increased costs is unfounded.”
Danielle Thompson holds a Master of Public Policy degree from Brandeis University and has extensive experience on this issue. Her research notes, “There is also extensive evidence that acupuncture is safe and effective, and can save insurers money in the long term, especially for patients with chronic disease. Numerous studies show that acupuncture can effectively treat symptoms from conditions such as migraine, cancer pain, fibromyalgia, and chronic pain in elderly patients among others.”
Thompson’s research points out that it is up to Massachusetts health insurance providers whether or not the insured receive acupuncture benefits. The major providers in Massachusetts are Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care and Tufts Health Plan. The research also notes that two recent acupuncture pieces of legislation died in committee since 2010 and that a new grassroots strategy is needed in Massachusetts. Thompson notes that policymakers need to be better educated regarding acupuncture and its inclusion in the health insurance system. Further, she notes reticence within the acupuncture community citing issues with health insurance paperwork and reimbursement rate issues associated with inclusion. Thompson points out that inclusion of acupuncture within the health insurance system is necessary to legitimize the perception of acupuncture to the general public and other health care providers. She also notes that members of the Massachusetts legislature need to understand that acupuncture “is a viable cost-containment tool.”
Thompson cites Clout’s rules of influencing public policy: “Public policy makers weigh opinion as equal to fact.” With that, she notes that AOMSM and its partners need to create a mailing list of patients who have benefitted from acupuncture. She notes that the personal stories of recovery from these individuals can often be more convincing than evidence. She recommends inviting “untraditional allies” such as the business community, trade associations, physicians and the insurance industry to join the effort.
Thompson notes that Washington state has an ongoing battle between the acupuncture and insurance industries which threatens the acupuncture benefits now provided. On the other hand, California recently made the move of adopting a Kaiser Permanente health insurance plan as the basic minimum of care within the state. Here, acupuncture is mandated for all individual and small group policies and the usual insurance industry versus health care provider conflict is averted. A spokesperson from Kaiser Permanente publicly praised the adoption of their policy as a statewide standard. In a complete political role reversal, the insurance industry is now supportive of the acupuncture mandate. Perhaps AOMSM may take a page from California’s efforts to ensure smooth passage of comprehensive health care reform that includes acupuncture and oriental medicine.
1. HD 00393, AOMSM
2. Bailis, Lawrence. "A Grassroots Campaign to Expand Health Insurance Coverage of Acupuncture in Massachusetts." (2012).