On February 1, the House Energy and Commerce Health Subcommittee held a hearing on H.R. 485, the “Protecting Health Care for All Patients Act,” sponsored by Chair of the House Energy and Commerce Committee Cathy McMorris Rodgers (R-WA), Rep. Brad Wenstrup (R-OH), Rep. Michael Burgess (R-TX), and Rep. Jim Banks (R-IN). The bill would prohibit the usage of Quality-Adjusted Life Years (QALYs) by federal health care payers.
Prohibiting usage of the QALY across the federal government is a major policy priority for the Alliance for Aging Research.
“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. 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,” said Alliance President and CEO Sue Peschin, MHS, in a press release for the hearing. “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.”
Kandi Pickard, President and CEO of the National Down Syndrome Society, served as a witness during the hearing and spoke for the major benefits of the legislation. She testified to the problematic implications of the QALY and other discriminatory metrics for patient access to care. U.S. Rep. Anna Eshoo (D-CA) and several other notable representatives from both sides of the aisle agreed that the QALY is a discriminatory metric that has no place in the federal healthcare system.
The Alliance remains hopeful that Congress will pass a total ban on the QALY and other discriminatory metrics in the near future. To learn more about the QALY and its discriminatory impact, read the Alliance’s report, “ICER Reviews and the Aging Population” or visit ICERfacts.org.
