As members of Congress, when presented with a problem we always tried to find a solution that addressed the human need while also making good economic sense. The Lymphedema Treatment Act (S.518/H.R.1948) is good policy and good politics, and we urge our former colleagues to enact this commonsense solution to a growing problem.
Lymphedema (chronic lymphatic system failure) affects an estimated 3-5 million men, women and children in the United States. There is no cure, but it can be effectively managed. Two-thirds of all cases are the result of cancer treatments that remove lymph nodes or damage the lymphatic system, making it a significant survivorship issue. Lymphedema affects 40 percent of all breast cancer survivors, which has the highest incidence rate, and 15 percent of cancer survivors overall. As survivorship increases, so too are the number of cases of lymphedema.
{mosads}In 2009 I met Heather Ferguson of Charlotte, N.C., as her newly elected congressman. Her three-year-old son had been denied insurance coverage for the compression garments he would need to treat and manage his lymphedema for the rest of his life. She had learned that her private insurance did not cover these doctor-prescribed medical supplies because they were following the standard set by Medicare, and rather than just try to obtain coverage for her child, she wanted to fix the problem. Not long after their meeting I introduced the first Lymphedema Treatment Act bill.
Medicare’s failure to cover prescription medical compression supplies simply because they do not fit in to an existing benefit category cannot continue. Nor should the unsustainable policy of spending more to treat complications rather than investing less to prevent them.
In 2012, Elaine Eigeman, a Washington state breast cancer survivor with lymphedema in both arms and hands asked Congressman Reichert to carry the torch, as I would not be returning to Congress. Over the subsequent six years my friend Dave Reichert championed the bill, elevating it to a level of support rarely seen. With 451 co-sponsors– 385 in the House and 66 in the Senate – the Lymphedema Treatment Act was the most supported health care bill in the 115th Congress.
Untreated or undertreated lymphedema results in increased complications, hospitalizations, comorbidities and disabilities. Mandated private insurance coverage in the Commonwealth of Virginia, which has been in place for more than a decade, has reduced physician and therapy visits by over 40 percent and reduced hospitalizations by over 50 percent.
Today, we call on our former colleagues to finish what we started. To close an unintended gap in Medicare coverage that prevents beneficiaries – and many other Americans with insurance policies that follow the Medicare standard – from accessing these vital medical supplies. Doing so will improve patient care while saving millions.
This bill presents a commonsense solution to a fixable problem. It will help millions of Americans, the majority of them cancer survivors, lead healthier, more productive lives, while saving precious health care dollars. As demonstrated by the level of support for this bill, this is something Democrats and Republicans can all agree on – it’s time to pass the Lymphedema Treatment Act.
Dave Reichert served 33 years in the King County Sheriff’s Office and retired from the House in January 2019 after serving seven terms representing Washington’s 8th District. Larry Kissell spent 38 years in manufacturing, eight years teaching high school, and retired from the House in January 2013 after serving two terms representing North Carolina’s 8th District.