The U.S. House of Representatives has approved a bill that would ban federal programs from using so-called quality-adjusted life years (QALYs), but it is unclear whether the bill will move forward. (Sink stock)
The U.S. House of Representatives passed a resolution banning Medicaid and other federal programs from considering quality of life measures that could be used to discriminate against people with disabilities, but the bill’s future remains uncertain.
The bill, known as the Health Care Protection for All Act, passed last week on a party-line vote of 211 to 208.
The bill would prohibit federal health programs from using a metric called quality-adjusted life years (QALYs), which considers whether a treatment is sufficiently cost-effective to justify it.
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According to a 2019 report, “A QALY is defined as the value of a year of treatment reduced by the degree to which an illness, disability, or other health condition is perceived as negatively impacting quality of life in that year.” The National Council on Disability’s report found evidence that QALYs can be used to discriminate against people with disabilities, and that governments should It recommended that measures be taken to curb its use.
Current law already prohibits Medicare’s use of QALYs, but the bill would extend coverage to all federal programs, including Medicaid.
“QALY and other similar discriminatory measures assign a dollar value to a patient’s life to determine whether a particular treatment is cost-effective, and they “We often discount the value and need for care,” the congressman said. The bill’s sponsor, Kathy McMorris Rodgers (R-Wash.), took to the floor of the House of Representatives. “Measures like QALYs no longer require consideration of a patient’s unique circumstances, health status, and physician judgment when deciding what is best for the patient.”
More than 90 disability and health advocacy groups, including the National Down Syndrome Association, Cerebral Palsy Coalition, and Autism Self-Advocacy Network, support the bill, which extends protections already provided by the Medicare program to Medicaid. and claims to comply with the recommendations. of the National Council for Persons with Disabilities.
“It is well documented that the use of these measures creates barriers to care due to the assumption that people with disabilities have a poor quality of life and are not deserving of treatment,” the organizations said in a statement. Ta. “Therefore, we urge Democrats and Republicans to come together on a bipartisan basis to pass legislation that weakens the (Affordable Care Act) and (Inflation Control Act) protections for the use of QALYs and similar measures. We strongly urge you to avoid making such amendments.”
But Democrats on Capitol Hill and the White House opposed the bill, warning that it would destroy existing protections in the law and pay for it by taking funding away from critical public health programs. ing.
“Federal law, including the Inflation Control Act, already prohibits Medicare from using QALYs to determine coverage, and state Medicaid programs are required by law to cover all drugs.” said Congressman Frank Pallone (D.N.J.). on the house floor. “Instead, H.R. 485 goes further than current law and opens a backdoor that prohibits the federal government from using any value measures, and these measures cannot be used by federal agencies such as the Centers for Medicare and Medicaid Services or federal agencies. It is used by agencies that require the Department of Veterans Affairs and states to negotiate fair prices for prescription drugs.”
Pallone said he had sought to include an amendment to make it clear that the bill could not be used to undermine federal efforts to lower prescription drug prices, but the proposal was defeated by Republicans. .
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