Call To Arms

[July 25th, 2007]

Amputees living in Oregon got a boost last month when Gov. Ted Kulongoski signed House Bill 2517.

The new law going into effect Jan. 1, 2008, mandates that insurance companies operating in Oregon offer coverage for orthotic and prosthetic devices, with no caps on how much they will spend on the items. And the state Department of Consumer and Business Services is also working on rules that will govern co-pays for those devices.

The bill is the product of three years' hard work by Matthew Bradley—a 30-year-old resident in orthopedic surgery at OHSU who lost his right leg in an auto accident when he was 10.

Co-sponsored by Reps. Peter Buckley (D-Ashland) and Sal Esquivel (R-Medford), along with Sen. Alan Bates (D-Ashland), the bill passed this session after Bradley spent three years traveling frequently to Salem for meetings with lawmakers.

"Outside of my residency, passing the bill was the biggest thing in my life," says Bradley.

The American Amputee Foundation of Oregon estimates there are 3,760 amputees in the state. One of those is Tarver Hannant (see "A Leg Up," WW, June 28, 2007), who's been raising money for a leg by selling T-shirts that read, "This shirt bought Tarver a leg."

"I'm glad someone in Oregon finally got fed up with the status quo with these insurance companies and did something about it," says Hannant, who's getting a temporary artificial left leg from a man who had an artificial leg before dying of cancer.

The someone who got fed up is Bradley. Growing up in the tiny hamlet of Leo, Ind., Bradley dreamed of being another Indiana hoops legend, Larry Bird.

But after playing hide-and-seek in the cornfields one summer day, Bradley was sitting on his bicycle off the side of the road when a car veered off of the shoulder and slammed into him.

Doctors told his parents that their son would probably not survive injuries that included punctured lungs, a fractured pelvis, and a lacerated liver and femoral artery. His right leg had to be amputated mid-thigh.

The expense of replacing his artificial leg, which Bradley rapidly outgrew, ran to tens of thousands of dollars. And that placed a heavy financial burden on his father—a medical-supply salesman—and mother, a college student/homemaker. They had Blue Cross insurance but their claim was denied—because Blue Cross said the prosthesis was not medically necessary.

Bradley says his dad had to work another job in the evenings, a memory that prompted him to press years later for HB 2517 in Oregon.

"I wrote it so families like mine wouldn't have to cash out their insurance policies or mortgage their homes just so their kid can have an artificial limb," says Bradley, who has two children—3-year-old Rachel and 11-month-old Ryan—with his wife, Elizabeth, a physical therapist who is now a full-time mom.

"I never forgot that," he says. "I've wanted to do something to change that system since I was 15 or 16."

Colorado, Maine, Massachusetts, New Hampshire, California and Rhode Island have passed legislation similar to Oregon's HB 2517. And 28 other states have bills in progress, according to Morgan Sheets, national advocacy director for the Amputee Coalition of America.

The coalition hopes to pass a similar federal bill in Congress before the end of the year. The chances of that are excellent, according to Sheets, because there are now so many state precedents and strong bipartisan support.

Lezli Goheen, public relations manager for HealthNet Health Plans of Oregon—a Tigard-based insurer that provides group, Medicare, individual and family plans—says it's too early for insurance companies to predict the impact of HB 2517.

"We're waiting for the state insurance officials to complete the rule-making process before we do anything," Goheen says.

As for what's next for Bradley, he hopes one day to open a clinic. It would be a place where amputees could get help, from pre-amputation counseling to prosthesis fittings and replacements. Meanwhile, he visits patients at home, counsels them before and after amputations, and makes himself available to meet with youngsters in the evenings.

"I was in their position 20 years ago, and I know what it's like to go through it," he says. "You cannot learn something like that from a book."

Bradley obviously would not wish an accident like his on anyone else, but says, "I've met exceptional people because of it, and I've got a career that I love, so I would not change a thing."