Acupuncture Continuing Education

Acupuncture Health Insurance Gets Boost

The AAAOM (American Association of Acupuncture & Oriental Medicine) has drafted five new federal acupuncture bills. Acupuncture gets a big boost with insuarnce benefits on the federal level. They are now calling for comments on the drafts in a letter to AAAOM members and colleagues of the acupuncture profession. In the letter, the AAAOM cites a generous donation by Five Branches University (Santa Cruz & San Jose, California) to the Acupuncture Action Fund that has enabled the drafting of these five bills. The comment period concludes at the end of August and interested parties are encouraged to visit the AAAOM website to enter their suggestions.

The first draft seeks to include acupuncture as a benefit to federal employees. The second draft bill seeks to add acupuncture benefits for military members and military dependents. The third draft bill seeks to ensure access to acupuncturist services through the Veterans Administration. The fourth draft bill seeks to add acupuncturist services to the Medicare system. The fifth and final draft bill seeks to add acupuncturists to the regular and reserve corps of the Public Health Service Commissioned Corps.

Several states including California and Maryland have already passed legislation to add acupuncture as a mandatory health care benefit to all individual and small group health insurance plans. This type of legislation was in response to requirements by the Patient Protection and Affordability Act (PPAA) for states to clarify and establish basic standards for health care insurance policies. The AAAOM seeks to further expansion of health care benefits to consumers by drafting these five bill proposals.

Pushback has been extreme by both the insurance industry and in the US Congress. Many congressmen threaten to shut down the federal government by refusing to fund any government budget or debt ceiling legislation so long as PPAA related programs receive funding. On the insurance industry side, consumers face higher deductibles and insurance premiums with reduced health care benefits. One extreme that has been observed is that a major insurance carrier has set a high deductible combined with a maximum number of acupuncture visits per year. Once the deductible has been met, the maximum number of visits has already been met and the consumer receives no acupuncture coverage. This applies to many insurance policies. It is extreme in that it is mathematically impossible for consumers to receive acupuncture benefits even though they have paid for the benefits. Naturally, not all insurance policies have such limitations but consumers are experiencing less reimbursements for many medical expenses as a general trend.

The dirty little secret is an old law that is on the books to this day. It protects insurance companies against antitrust legislation and has enabled enormous abuses including price fixing. The McCarran-Ferguson Act of 1945 gives insurance companies exemption from antitrust laws. It allows them to legally fix prices, collude with one another and to divide market turf amongst themselves.

President Obama favors repealing antitrust protections for insurance companies. The US House of Representative voted to repeal antitrust protections for insurance companies by a vote of 406 to 19 back in February of 2010 through the Health Insurance Industry Fair Compensation Act. The act had 70 cosponsors and a total of 253 Democrats voted in favor of the legislation joined by 153 Republicans. The only nays came from a small group of 19 Republicans. The act sailed through the House in two days providing easy passage. The passage of this historic act received muted attention by the press. The Senate never agreed on the provisions and the bill never gained any further traction. Nonetheless, the passage of the PPAA followed shortly thereafter.

The AAAOM recognises the focus of legislation, both pro and con, on the issue of health care. In this environment, they have initiated a process that may lead to implementation and access to acupuncturist services and acupuncture on the federal level. Political insiders suggest that a 2014 election cycle favoring the Democratic Party in the US House of Representatives is the road to passage acupuncture health insurance benefit legislation.