Early voting is underway in Texas, where I live. Being immunocompromised, I applied for and received a mail-in ballot. With the validity of mail-in voting in question and with healthcare at stake, I’ve decided to surrender my mail-in ballot and risk my health by voting in person.
Inflammatory bowel disease (IBD) patients should exercise their right to vote. Aside from deciding the future of the Affordable Care Act (ACA), our elected officials could shape healthcare for years to come. Before heading to the polls, I researched what IBD-related issues could be discussed on Capitol Hill.
The Crohn’s and Colitis Caucus
In 2011, the U.S. House of Representatives partnered with the Crohn’s & Colitis Foundation to form the bipartisan Crohn’s and Colitis Caucus. The caucus advocates for patient care, raises awareness about IBD, and allocates funding for research. As of late 2019, more than 60 representatives had joined the caucus.
I was surprised that only one of the 36 Texas representatives is a caucus member. The first item on my post-election to-do list is to encourage my incoming district representative to join once he takes office.
The Safe Step Act (HR 2279/S 2546)
Most health insurance companies insist patients undergo step therapy to receive medications prescribed by their providers. Before insurance covers an expensive treatment, the patient must try and fail less expensive — and often less effective — medications. As a result, the patient’s symptoms and quality of life usually worsen.
In April 2019, Rep. Raul Ruiz (D-CA) introduced House Bill 2279, which was co-sponsored by 150 representatives from both sides of the aisle. A few months later, Sen. Lisa Murkowski (R-AK) and 16 bipartisan co-sponsors introduced Senate Bill 2546. Known as the Safe Step Act, the law would allow patients to receive appropriate medications without undergoing step therapy protocol. It would also demand a transparent and expedient appeals process if insurance denies coverage.
My representative and senators didn’t co-sponsor either bill. However, Texas passed step therapy reform in September 2017, joining more than 25 states with step therapy legislation.
The Restroom Access Act
In August 2005, Illinois became the first state to pass the Restroom Access Act after a young Crohn’s patient, Ally Bain, soiled herself when employees at a store refused to let her use an employee restroom. Also known as Ally’s Law, it requires businesses to permit customers with IBD to use employee restrooms when public facilities aren’t available.
The law applies only when two or more employees are present and the use of the restroom isn’t a risk to the patient or the business. The business may require documentation of a patient’s medical condition.
As of September, 17 states have enacted a Restroom Access Act. Although Texas passed the law in 2007, I didn’t learn about it until a few years ago. Now, I always carry my Crohn’s & Colitis Foundation “I Can’t Wait” card.
The Affordable Care Act and civil rights protections
Since President Barack Obama signed the Affordable Care Act into law in 2010, health insurance companies can’t deny coverage to IBD patients or charge more for preexisting conditions. ACA also abolished annual and lifetime limits on patients’ essential healthcare. IBD patients aged 26 and younger can remain on a parent’s plan, and more patients are eligible for Medicaid. Preventive care, including stool tests and routine colonoscopies that screen for colorectal cancer, are free.
IBD patients could lose these healthcare protections and more if the U.S. Supreme Court rules the law unconstitutional. The court will hear arguments on Nov. 10, a week after Election Day in the U.S.
Even if ACA remains the law of the land, the Department of Health and Human Services (HHS) has already weakened Section 1557. Section 1557 upholds federal civil rights laws that prevent providers and insurance companies from discriminating against patients based on race, color, national origin, sexual orientation, or disability.
Last June, the HHS ruled that insurance companies and providers can refuse healthcare coverage and medical services based on the patient’s gender identity and sexual orientation as well as the provider’s religious beliefs. The U.S. Supreme Court and two federal District Courts blocked this revision shortly after it was to take effect in August. However, the rule limiting interpretation and translation services for non-English-speaking patients stands.
Other healthcare policy issues
In addition to the issues above, Congress has presented bills such as the Patients’ Access to Treatments Act, the Medical Nutrition Equity Act, and the Lower Health Care Costs Act. IBD patients will elect the representatives and senators who will debate these causes on our behalf and the president who will ultimately sign them into law. Our congressional members will also appropriate the Department of Defense budget that funds IBD research and development.
By understanding what’s at stake, IBD patients can decide our healthcare at the polls. To help, the Crohn’s & Colitis Foundation has a chart showing current congressional members who support IBD policy.
Note: IBD News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of IBD News Today, or its parent company, BioNews, and are intended to spark discussion about issues pertaining to IBD.