Chairs Rodgers, Smith and Reps. Burgess, Wenstrup Introduce Legislation to Ban QALYs
Bill Would Protect Individuals with Disabilities from Discrimination
Washington, D.C. — House Energy and Commerce Committee Chair Cathy McMorris Rodgers (R-WA), House Ways and Means Committee Chair Jason Smith (R-MO), and GOP Doctors Caucus Co-Chairs Rep. Brad Wenstrup, D.P.M. (R-OH), and Rep. Michael Burgess, M.D. (R-TX), announced introduction of H.R. 485, the Protecting Health Care for All Patients Act, which would expand access to lifesaving cures and prevent discrimination against Americans with disabilities. The House Energy and Commerce Committee Subcommittee on Health will consider the bill at a February 1, 2023, legislative hearing titled: “Lives Worth Living: Addressing the Fentanyl Crisis, Protecting Critical Lifelines, and Combatting Discrimination Against Those with Disabilities.”
"All lives are worth living. It’s unconscionable that a health care bureaucracy would so callously determine that someone’s life is worth less. They deserve every chance to have hope and reach their full potential. The ‘quality-adjusted life years’ measurement is used to discriminate against people with chronic illnesses and disabilities, like cystic fibrosis, ALS, or Down syndrome, putting them at the back of the line for treatment. Moving this legislation will be a priority for our committee,” said House Energy and Commerce Committee Chair Cathy McMorris Rodgers.
“Washington bureaucrats have no business picking and choosing which Americans are worthy of receiving treatment for serious, and often life-threatening, health issues,” said House Ways and Means Committee Chairman Jason Smith. “The ‘quality-adjusted life years’ measurement is discriminatory, morally bankrupt, and has no place in our health care system. I’m proud to join Chair Rodgers and Congressmen Burgess and Wenstrup in this effort to halt the government’s shameless attempt to decide if someone’s life is worth living.”
"I practiced as an Ob/Gyn for nearly 30 years. During that time, I treated each patient as a human being, not just a diagnosis. Quality-Adjusted Life Year (QALY) measurements are cruel and inhibit physicians' ability to care for and treat all patients with dignity. The government should never have the ability to decide the value of a life to approve or deny care. All human life has inherent value and should be treated as such," said Rep. Michael Burgess, M.D.
“I am proud to join my colleagues to introduce legislation that stops the use of quality-adjusted life years (QALYs) in Federal programs. QALY measurements put a dollar value on a person’s life, often devaluing the lives of those with chronic illnesses and disabilities. As a physician, I believe it is vitally important that our health care system values all lives and ensures that every person is treated with dignity,” said Rep. Brad Wenstrup, D.P.M.
H.R. 485 would prohibit the use of quality adjusted life years (QALYs) in all federal programs—an expansion from the current prohibition that only applies in a limited fashion to the Medicare program.
The controversial metric intentionally devalues treatments for disabled individuals and those with chronic illnesses for purposes of determining whether the treatment is cost-effective enough to be paid for by the federal government. The use of QALYs is a clear form of discrimination. The bill would also prohibit the importation of price-controls from countries that use QALYs, which are a socialist trademark of government-run health insurance programs.
What They’re Saying:
“It’s hard to believe that it’s 2023 and patients with chronic illness are fighting to be treated like human beings. Congress can transform the lives of Americans with chronic disease by stopping the government use of an arbitrary metric that decides what our lives are worth,” said Terry Wilcox, CEO of Patients Rising. “Chair Rodgers didn’t waste any time defending the rights of the patients who will overwhelmingly be the targets of this calculation when determining access to care. She knows they are not worth less than anyone else, and we’re eager to join that fight.”
"The use of Quality-Adjusted Life Years is a longstanding concern in the disability community, especially in health care. The QALY inappropriately devalues the lives of people with disabilities and chronic conditions like epilepsy and can result in discriminatory limits on access needed health care services and treatments. We are glad to see this legislation to ban their use in federal health care programs included in the first hearing of the Energy & Commerce health subcommittee this Congress,” said Laura Weidner, Vice President of Government Relations & Advocacy, Epilepsy Foundation.
“The quality-adjusted life year (QALY) devalues the lives of older adults, people with disabilities and chronic conditions, and communities of color. The National Council on Disability has repeatedly warned against the use of QALYs in healthcare decision making because it would undermine major U.S. disability and civil rights laws, including the Rehabilitation Act and the Americans with Disabilities Act,” said Sue Peschin, MHS, President and CEO of the Alliance for Aging Research. “Despite the obvious negative impacts on health equity, payers—including private insurers, the Veterans Administration, and state Medicaid agencies—are increasingly utilizing QALY-based cost-effectiveness analyses from the Institute for Clinical and Economic Review (ICER) to ration access for FDA-approved treatments. It is time for these harmful practices to stop. The Alliance applauds Energy & Commerce Chair Cathy McMorris Rodgers, Ways & Means Chair Jason Smith, and Doc Caucus Co-Chairs Rep. Brad Wenstrup and Rep. Michael Burgess for their leadership on the introduction of the Protecting Health Care for All Patients Act of 2023 and urges Congress to pass this vital legislation.”
“National Right to Life applauds Chairs Cathy McMorris Rodgers and Jason Smith as well as Reps. Michael Burgess and Brad Wenstrup for introducing the ‘Protecting Health Care for All Patients Act.’ This legislation would prevent the use of Quality-Adjusted Life Year (QALY) or similar metrics in health coverage. QALYs are an inherently discriminatory system of rationing used to assess a person’s anticipated lifespan and whether treatment will be ‘cost effective.’ QALYs apply a score to a person’s health and penalize a person who has a disability. QALYs are being used by some health care systems and payers to determine whether a patient who is judged—by others—to have a ‘diminished quality of life’ should receive health care coverage. National Right to Life strongly supports this life-affirming, dignity-enhancing legislation," said Jennifer Popik, Director of Federal Legislation at the National Right to Life Committee.
"As the mother of a child with a disability, I'm deeply disturbed by the federal government's use of QALY; it is a dehumanizing methodology that discriminates against the elderly and sickest among us. I've seen how life-saving drugs that help fight my daughter's cystic fibrosis have been denied in other countries because government bureaucrats have deemed it 'too costly.' That is unacceptable and will lead us on a path toward socialized medicine. Thankfully, this legislation will help provide access to care that Americans deserve and send an important moral statement that our nation cares for our most vulnerable," said Mary Vought, Fellow at the Independent Women’s Voice and former National Council on Disability Council Member