Dr. Jeffrey Cain likes to make an analogy.
Imagine you had a child, but were told you would only be able to afford one pair of shoes for that child. When would you buy them? How could you make the choice?
That's the decision private healthcare companies often force the families of amputees to make, said Cain, the chair of the Amputee Coalition of America's advocacy committee.
Federal healthcare programs, such as Medicare, Medicaid and insurance provided by the Department of Veterans Affairs, cover prosthetics upgrades, meaning children can have their prosthetics replaced when they outgrow them, and adults when needed. The policies also ensure amputees can stay current with technological upgrades, Cain said.
But many private insurance companies include one-limb-per-lifetime caps, or offer limited coverage, such as paying $5,000 for a $20,000 prosthetic, Cain said.
That's why the ACA is backing the Prosthetic and Customized Orthotic Act, which would require private insurance companies to offer the same benefits for amputees as federal healthcare. Sen. Bob Casey Jr., D-Pa., and Rep. Todd Platts, R-York County, both support the bill, which is expected to be introduced later this year. Sen. Arlen Specter, R-Pa., has not taken a position on it yet.
Eleven states have passed similar legislation, Cain said, and another 30 are considering it. But, he added, companies with more than 5,000 employees who self-insure -- the type of companies that employ half the country's private workers -- are exempt from state regulations.
The law, he says, makes sense.
Fitting amputees with the correct prosthetics allows them to live full and productive lives, Cain said, and, it keeps them in the workforce, meaning they don't have to collect unemployment benefits.
"This only costs pennies when spread across the population and it saves the government money," Cain said.
The first year after Colorado passed similar legislation, Cain said, the state saved $500,000.
The most common cause of amputation is diabetes, Cain said, and with diabetes expected to rise in the population, the number of amputees is expected to grow from the current 1.7 million.