Affordable Care Act: Revisited

The Affordable Care Act or ACA has been constantly in the news since October last year when the (largely faulty) exchange websites went live.  Yes, the health care exchange rollout has been fraught with difficulty and enrollment has been challenging, but despite these issues, I personally feel the Affordable Care Act is an amazing success - over a million uninsured Americans have signed up for coverage already!  It is truly is a landmark piece of legislation not only for America as a whole, but for Acupuncturists in particular.

Though insurance companies have been able to extend existing plans a little longer due to the 2 year grace period the feds announced last week, under the Affordable Care Act more people have access to Acupuncture and alternative medicine coverage in the United States than ever before.  Under ACA, alternative medicine is poised to thrive because:

1. Five states (Alaska, California, Maryland, New Mexico and Washington) chose to include Acupuncture benefits as standard care in addition to the 10 Essential Benefits outlined in ACA.  All insurance plans originating in these states going forward will include Acupuncture coverage!
   
2. The government’s definition for the “healthcare workforce” in America now includes Complementary and Alternative Medicine (CAM) providers, meaning a national recognition for Acupuncturists as part of the medical team.
3. The Affordable Care Act includes a special clause in section 2706 for “non discrimination in healthcare” which means that if insurers cover Acupuncture and Acupuncture is provided by a Licensed Acupuncturist they cannot deny coverage. In the past, some health care plans would say they covered acupuncture, but would only pay if it was provided by a Medical Doctor (with a weekend course of training or even none at all, compared to the 3-5 year Master’s Degree an LAc is required).
4. A new research institute was formed specifically to do outcomes based research on Complementary and Alternative Medicine treatments. In time this will GREATLY improve everyone’s understanding - CAM providers, consumers and medical doctors alike - of where CAM services provide the best benefits as compared to Western Medicine or “standard care.”

As to the last clause above, this kind of research is being done slowly but surely in Europe and has resulted in some great advances for Acupuncturists in Germany in particular.  A study on back pain and knee arthritis called The German Acupuncture Trials showed that Acupuncture and standard care both resulted in approximately the same outcome.  Subsequently, Acupuncture is now covered by socialized German healthcare for these conditions.

More studies like this conducted in (and therefore recognized by) the U.S. will result in everyone making better decisions about medical intervention at various stages.  If you had a choice between arthroscopic knee surgery for osteoarthritis ($50,000 price tag) and acupuncture (6-12 visits at $70 each) which would you, and your insurance company, choose knowing the outcome would be approximately the same?  Acupuncture is the clear winner for the average case - less expensive, less invasive, virtually risk free, natural and research-proven to be effective! 

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An Acupuncturists Perspective on the Affordable Care Act

From an Acupuncturists perspective, these things are a big win for our industry.  The Affordable Care Act has resulted in increased access to Acupuncture by 

• Recognizing Acupuncturists as health care professionals on a national level
• Providing for further comparative research studies that will have direct impact on how and when to use Acupuncture compared to standard care, instead of constantly researching the question “how does Acupuncture work?” which has many biomedical answers that may or may not affect utilization of services
• Increasing access to healthcare overall including Acupuncture
• Protecting Acupuncturists ability to provide Acupuncture as defined in scope of practice with the new “non discrimination in healthcare” law.

The Affordable Care Act is an incredible first step towards something desperately needed in our country - true health care access for all as a national right.  Is it perfect? Not quite.  Is it going to continue to go through changes in the coming years? Undoubtedly.  But the standard has been set and (hopefully!) there’s no going back now.

Wondering if your insurance covers Acupuncture? I’m always happy to check benefits for potential patients, so if you want to check your benefits please email me your name, date of birth and health insurance information and I’ll be happy to verify your benefits before your first visit or consultation!

Until next time,

~Rebecca