Today, the House reintroduced legislation - modeled on what was known as H.R. 3 when it was introduced in 2019 - that would rely on quality-adjusted life years (QALYs) to value health care, which are well known to discriminate against people with disabling and chronic conditions, especially in communities of color that are not well represented in the research literature.
Going forward, I am excited that the disability and patient communities are united in amplifying the work of the National Council on Disability, an independent federal agency that has warned policymakers on the implications of referencing QALYs directly and by reference to third parties and foreign countries. They have provided great leadership by recommending policymakers avoid referencing QALYs due to their discriminatory implications in their 2019 report, their recommendations for the previous administration to rescind QALY-based policies relying on an international pricing index or “Most Favored Nation,” and most recently theirletter to the Congressional Budget Office highlighting that CBO makes light of QALYs assignment of lower value to disabled life when utilizing the QALY as a metric to assess cost savings of the bill as it was introduced in 2019.
Almost 90 organizations representing people with disabling and chronic conditions and older adults signed an Open Letter last week calling on policymakers to work to ensure the most vulnerable populations among us are not denied coverage or access to high quality health care based on discriminatory measurements of a treatment’s value. Every person is valuable. We know there is a history of strong bipartisan opposition to the use of QALYs and discriminatory metrics that reinforce health inequities. We saw that bipartisanship when the Affordable Care Act passed with a bar on the use of QALYs in Medicare and have seen opposition to QALYs reiterated in the DNC Platform.
In light of the pandemic and the inequities that are finally being recognized for what they are in our health system, I look forward to Congress working on solutions that address the cost of care that has impacted so many people and their families without discrimination. We can and must do better for every person, including people with disabilities or a chronic condition.
Thank you for the work you are doing toward a better health care system!