OP-ED CONTRIBUTOR

Health Care Bill Should Serve Those Who Need It Most

As Senate leaders prepare to vote on the Better Care Reconciliation Act of 2017, doctors and patients across the nation are urging our elected officials to pass a health care bill they can believe in — one that truly makes insurance coverage affordable and accessible to those who need it most.

One particular group of Americans — the 1 in 4 U.S. adults who live with arthritis and other rheumatologic diseases — has a lot riding on the Senate’s actions in the days ahead. Access to care and coverage can mean the difference between being functional or disabled for people living with rheumatoid arthritis, lupus or one of hundreds of other painful and debilitating rheumatologic diseases.

In its mildest form, arthritis can cause pain and some difficulty with everyday tasks. But in many cases, it causes severe pain, swelling, joint deformity and debilitating, life-altering lifestyle restrictions. In fact, arthritis and other rheumatologic conditions are the country’s leading cause of disability, generating more than $128 billion in annual health care costs.

Appropriate and timely care provided by a rheumatologist can help patients manage their symptoms, avoid permanent disability and have a normal lifestyle that allows them to remain active and contribute to their communities. Treatments such as disease-modifying anti-rheumatic drugs and biologics can help to slow, stop and sometimes even reverse disease progression, thereby preventing crippling joint damage before it even starts. That is why continuous coverage and affordable access to high-quality care and medications are so critical. Studies have shown that cost-related delays or lapses in care and treatments for rheumatologic diseases can lead to disease progression, increased disability and worsening health.

As terrible as treatment delays are to a patient’s health, lapses in coverage could spell disaster for their finances. Under the current version of the AHCA, states could receive federal waivers allowing insurers to charge high premiums to any patient who may have allowed their coverage to lapse for more than 63 days during the past year. The result for these individuals would be crushing medical debt, or the unaffordability and inaccessibility of health care – both undesirable outcomes.

Americans want and deserve access to quality, affordable health care. Americans with rheumatologic diseases will suffer greatly without it. With the interests of these more than 54 million Americans in mind, the U.S. rheumatology community hopes the Senate will pass legislation that protects and promotes access to adequate and affordable health insurance.

Arthritis patients need to be protected from exclusions based on their pre-existing conditions. Most forms of arthritis and other rheumatologic diseases tend to be chronic and require long-term treatment that can span years and sometimes even lifetimes. These patients need affordable premiums, deductibles and cost-sharing, which will ensure access to medically necessary rheumatologic treatments such as DMARDs and biologics. It is also critical to maintain the ban on lifetime maximums and the cap on annual out-of-pocket spending. And they need the assured protection of essential health benefits in order to receive a range of needed health care services.

We have shared these recommendations with our Senate leaders in the hopes that they will take these principles into consideration and pass a health care reform bill that works for those who need affordable, consistent care the most.

 

Sharad Lakhanpal is president of the American College of Rheumatology. Ann M. Palmer is president and CEO of the Arthritis Foundation.

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