By Brandon Hoffmann, Special to The MAHA Report
For 50 years, the federal government has been telling seniors that only one chiropractic service counts. Medicare Part B pays for a chiropractor’s manual manipulation of the spine – known as an adjustment – and nothing else. Not the physical exam. Not the X-ray. Not the other care that chiropractors are licensed and trained to deliver in their states. Federal regulation says so in plain language, and roughly 28.5 million people, with fee-for-service Medicare Part B, live with the result.
Here is what that means in practice. A senior who chooses conservative care must pay out of pocket for the necessary services Medicare will not cover.
On a fixed income, that cost is a barrier, and it produces a backwards outcome: the lowest-cost, safest treatment path becomes the unaffordable one, while Medicare readily pays for the expensive alternatives at hospitals, including MRIs and CT scans, injections, surgery, opioid prescriptions, and emergency room visits.
No one asks what works best or costs least. The only question the system answers is what is covered, and seniors are routed accordingly.
The research says exactly what common sense says. Peer-reviewed studies conducted in the Medicare population itself have found that older adults who use chiropractic care have lower overall costs and fewer back surgeries, a 56 percent lower risk of filling an opioid prescription, and less decline in physical function after one year. And when seniors lose access to chiropractic care, primary care visits, spine surgeries, and Medicare spending all rise.
If all seniors on Medicare lost access to chiropractic care, the added cost would be an estimated $391 million a year. H.R. 539, the Chiropractic Medicare Coverage Modernization Act, is the fix, and it is the rare bill that has both the American Chiropractic Association and the International Chiropractors Association behind it. Both are working side by side with the MAHA movement to pass it. It has 169 cosponsors in the House – 97 Republicans and 72 Democrats.
Chiropractors are also united behind three amendments that make the bill better: a firm implementation date; coverage tied to state-authorized scope with drugs; surgery and obstetrics expressly excluded; and equal private-contracting rights.
Medicare already classifies chiropractors as physicians, yet they are the only physicians in the program denied the right to contract privately with their patients. So what is Congress waiting on? A cost estimate from the Congressional Budget Office, and a decision by House leadership, to move it. Nineteen months after introduction, neither has happened.
That is where MAHA supporters can help.
Members of Congress are home through the Labor Day weekend, at town halls, county fairs, and district offices, and will be listening to their constituents right before they return to Washington next week.
Three points to make, in person or by phone:
1. Medicare pays nothing today for an exam or X-ray done by a chiropractor, forcing seniors to pay out of pocket for the lowest-cost care while Medicare covers the expensive alternatives. This has to change.
2. H.R. 539 is bipartisan, with 169 House cosponsors from both parties. If your member has not cosponsored the bill, please ask them to consider co-sponsoring this important bill. . If they are already a co-sponsor, thank them and ask them to push leadership for a vote this fall. Either way, ask them to back passage with the three improvements the whole profession has agreed on: coverage based on what a chiropractor’s state license allows, with drugs, surgery, and obstetrics excluded; the same private-contracting rights every other Medicare physician-level provider has; and a firm implementation date.
3. Seniors on Medicare want an alternative to opioids, surgery, and the ER. Research on Medicare beneficiaries shows that conservative chiropractic care is connected to fewer opioid prescriptions, fewer surgeries, and lower costs.
Then take two minutes to put it in writing, where it gets counted. Here is exactly how:
Go to the MAHA Action legislative tracker, here.
If you are starting from the MAHA Action site instead, click Legislative Tracker, then View More Bills, then search HR 539. Type it with a space between HR and 539, or the search will come back empty.
Before you hit send, add a line of your own. The message box is editable, and a congressional office reads a personal story differently than it reads a form letter. If you or someone in your family has paid out of pocket for care that Medicare would not cover, say so in your own words. That one sentence is what a staffer remembers.
Congress returns in September with a short runway to Election Day. Make sure your member of Congress hears from you today on why HR 539 should pass and become law.
It would be about time! Instead of paying for illegals, give Americans what they need-seniors and younger!
And why limit this to Chiropractic care? There is an acupuncture for seniors act in Congress which has been languishing in committee for lack of support.