So Hoosiers Can Move

We believe movement is medicine and physical activity is a right, not a privilege. But today, thousands of Hoosiers living with limb loss, limb difference, and mobility impairment are unable to afford and access life-changing orthotic and prosthetic care that helps them be physically active due to inadequate insurance coverage, “not medically necessary” denials, and high out-of-pocket costs. So Every BODY Can Move advocates are working to change this.

PURSUING

Indiana

Bill Number:

Status:

Pursuing

Insurance Plans Affected:

State Commercial Plans

Types of Devices Covered:

Orthoses + Prostheses

State Leads:

Sierra Diller, Alicia Carver and Eric Schopmeyer

Primary Bill Sponsor:

Senator Andrea Hundley

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Sierra Diller

Co-State Lead, Disability Rights Advocate, Amputee

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Alicia Carver

Co-State Lead, Disability Rights Advocate, Amputee

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Eric Schopmeyer

Co-State Lead and Director of Operations at surestep

At a Glance

Hoosier Statistics

Physical activity is one of the most important factors in maintaining overall health throughout one’s lifetime. Whether it’s vigorous exercise or simple day-to-day movement, being physically active increases strength and balance, improves mental health, supports better-quality sleep, and reduces the risk of disease and cancer for every body, including people with disabilities.

4.5X

Children with disabilities are 4.5 times less likely to engage in physical activity compared to their peers.

American College of Sports Medicine, Why We Must Prioritize Equitable Access to Physical Activity for Children with Disabilities

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1 in 2

50% of adults with disabilities get absolutely no aerobic physical activity.

Centers for Disease Control and Prevention (CDC), Inactivity Related to Chronic Disease in Adults with Disabilities

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2X

Adults and children with mobility limitations are at greatest risk for obesity and the prevalence of obesity in children with disabilities is almost twice that of children without disabilities.

Centers for Disease Control and Prevention (CDC), Disability and Obesity

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60 / 150 Mins

The U.S. Department of Health and Human Services’ Physical Activity Guidelines for Americans recommends children with disabilities get 60 or more minutes each day of moderate or vigorous intensity aerobic physical activity; for adults with disabilities, the recommendation is 150 minutes weekly.

U.S. Department of Health and Human Services, Physical Activity Guidelines for Americans, 2nd Edition

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$44 Billion

Annual health care costs of obesity that are related to disability are estimated at approximately $44 billion.

Centers for Disease Control and Prevention (CDC), Disability and Obesity

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“F”

According to the 2022 U.S. Report Card on Physical Activity for Children and Youth, the U.S. received an “F” grade for children with disabilities, with less than 17.5% meeting the recommended daily physical activity.

Physical Activity Alliance, The 2022 United States Report Card on Physical Activity for Children and Youth

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Thousands of Hoosiers with limb loss, limb difference, and mobility impairment face difficulties in obtaining affordable and accessible prosthetic and orthotic care for physical activities and exercise because state, federal, and private health plans deem this care “not medically necessary.”

Without health plan coverage, adults, children, and families are forced to:

  • Incur prohibitive out-of-pocket costs (ranging from $5,000 -$50,000)
  • Risk harm/injury using an improper device
  • Live sedentary lifestyles with costly health complications including obesity

Individuals with disabilities need activity-specific prostheses and orthoses in order to participate in physical activity and recreation. Without access, physical activity is out of reach or dangerous when utilizing the wrong device. Putting more strain on a general-use prosthesis or orthosis may cause damage to the device, resulting in more expense for insurance providers.

Background Element 1 Background Element 2

What will this bill do?

This bill would require state commercial plans to provide coverage and reimbursement for orthotic and prosthetic care at a level that is equivalent to the federal Medicare program (also known as “insurance fairness or parity”) as well as provide coverage for an additional prosthetic or custom orthotic device for physical activity. The bill defines nondiscrimination standards, prohibits unfair trade practices, exempts reasonable useful lifetime restrictions, and deems orthotic and prosthetic care as an essential health benefit.

How this bill benefits Indiana

This bill will ensure every Hoosier covered by a state commercial plan that is living with limb loss, limb difference, or mobility impairment will have access to the prosthetic and orthotic care they need to regain their mobility and independence, return to work, and contribute to society. Ensuring appropriate prosthetic and orthotic coverage has a minimal impact on insurance premiums while reducing costly secondary health conditions including heart disease, diabetes, and obesity, as well as reducing reliance on public assistance.