Passage of Health Care Reform

ABMP Statement 3-29-2010
Bob Benson
ABMP Chairman

The debate is over, for now at least. The American system for providing health care to its citizens will be transformed during the next few years. How will massage therapy be impacted by the changes in law? Mostly in ways that are not so far a central part of the conversation within the massage community.

Much of the massage profession discussion about health care reform has focused on enhanced recognition of the value of massage therapy by the medical and insurance communities. Discussions leading to the new law offered at least implicit recognition of massage therapy’s value in promoting health and wellness. The new law provides for research into the effectiveness of alternative approaches to treatment, which potentially may support the value of complementary therapies for certain physical conditions. While this recognition is appreciated, some in the massage community remain disappointed that, under the new law, massage therapy did not achieve notable gains in eligibility for reimbursement, i.e. by becoming considered a health service eligible for reimbursement by health insurance plans.

While greater respect for complementary and integrative medicine may be a subtle outcome of this new era in health care, another aspect of reform will directly affect a substantial number of massage therapists. ABMP’s research shows approximately 28 percent of our 71,000 massage therapist members do not currently have health insurance coverage. That percentage is almost double the rate of uninsured persons in the general U.S. population (approximately 15%). Many massage therapists mix and match their work – engaging in combinations of solo practice, part-time employment, and/or contract work – in combinations that do not facilitate eligibility for affordable employer sponsored health insurance coverage.

Frustration and worry about this circumstance show up in ABMP surveys we conduct to better understand the needs of our members. Health insurance has historically been one of the most-requested member benefits. ABMP explored options for a member health insurance program several times over the past 15 years. Consistently we found that a cost-effective national plan for members was unrealistic from cost and logistical perspectives.

Starting in 2014, those massage therapists currently lacking health insurance coverage will be required to obtain such insurance or to pay a penalty tax. However, based upon ABMP surveys of member income levels, many such affected individuals will be eligible for substantial financial subsidies. Even individuals with diverse massage practice arrangements will be able to choose among several plans expected to be offered through newly created insurance exchanges. Right away in 2010, massage therapists under age 26 will be eligible to remain covered under a parent’s health insurance plan.

The new health care bill will also bring numerous changes to the 72% of our members currently covered by health insurance. Among them are elimination of rate discrimination against women and prohibitions against insurance companies being able to disqualify an applicant for insurance because of a pre-existing condition or to boot someone out of a health plan because they had the audacity to actually become ill.

The new law certainly is imperfect, hardly surprising in tackling a service that makes up one-sixth of the entire U.S. economy. Though it contains a number of thoughtful initiatives to address rising health care costs, compromises with powerful elements in the health care industry limit the likely impact of those measures. The reality is that every health care system in the world is challenged by rapidly rising costs. Some of those cost increases have to do with wonderful, but expensive, new medical technologies, some to wasteful practices such as unnecessary duplication of medical records, and some to raw market power. We each also own a piece of the problem: only when attention to personal wellness becomes widespread does our society have an opportunity to reduce health care costs meaningfully.

Whatever differences of viewpoints individuals expressed during the extended national policy debate, the reality is that within five years it appears that more than 90% of practicing massage therapists will have health insurance coverage – and all of us will be relieved of the fear of losing coverage if we become ill or lose our job. We share the hopes of many that reform will on balance prove to be a positive change that will provide greater stability, security, and better health to Americans, and especially so to massage and bodywork professionals who themselves work to improve the health of millions of Americans every day.