ADVOCACY NEWS: Vermont prosthetic parity bill signed


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MONTPELIER--AP--When Eileen Casey's bone cancer forced her to have a leg amputated below the knee, she was just getting ready to switch from a temporary to a permanent prosthetic limb when her health insurer told her she had hit her lifetime coverage limit of $10,000.

"I was absolutely heartbroken and devastated to discover that just having the temporary was leaving me with no coverage for the rest of my life," she said.

"It was shocking to find out I was going to have to take out a loan to buy myself a leg so I could keep working and living independently." At the bank, Casey said she "burst out crying when they asked me what the loan was for."

But the 49-year-old South Burlington woman, an advertising sales rep at WCAX-TV, quickly decided she would fight. Someone suggested she contact the state vocational rehabilitation office, which found it had enough money in its budget at year-end to give her an $18,000 grant for a new leg.

Then she contacted a local lawmaker, Sen. Doug Racine, D-Chittenden and chairman of the Senate Health and Welfare Committee. Their work paid off Wednesday when Gov. Jim Douglas signed into law a bill mandating that health insurers cover prosthetics at parity with other types of coverage.

She also recruited Timothy Pochop, 42, also of South Burlington, to her cause. Pochop, who lost part of a leg after a motorcycle accident last September, was running into similar problems. He attended the bill-signing and got to be a witness as Vermont became the 10th state in the country to enact a prosthetic parity law.

Pochop said his insurer, Cigna, "did a great job," handling his hospital bills, but that his lifetime limit for prosthetics was $1,000 with a $200 deductible.

"It didn't make sense that they would pay a quarter million dollars to get me out of the hospital ...

His wife, Rene, finished the sentence for him: "And not finish the job."

Casey said her employer is self-insured, that its health coverage is governed by federal law and won't be affected by the Vermont legislation. But she said she had contacted Sen. Bernie Sanders, I-Vt., and that he had agreed to introduce federal parity legislation.

Sanders' office issued a statement Wednesday quoting him saying, "I strongly support this legislation, which should be passed at the federal level as well. Health care decisions should be made by doctors and their patients, not insurance company bureaucrats."

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