Advocates press for insurance coverage of activity‑specific prostheses; insurers warn of cost and market effects

Sen. Bill Ganon and co‑sponsors reopened debate on legislation to require insurers to cover activity‑specific prostheses for adults once every five years. Ganon said the change aims to let veterans, athletes and ordinary residents maintain an active lifestyle and avoid chronic disease risks associated with inactivity.

Amputees and prosthetics clinicians described how activity‑specific devices — running blades, swim legs and sport‑specific terminal devices — support long‑term health, reduce secondary injuries and improve mental health. "Activity specific prostheses are not a luxury. They are a missing piece of rebuilding a full life," said Hudson Hammer, an amputee who testified in support.

Insurance carriers and the Department of Insurance urged narrow drafting. Commissioner DJ Betton Court said the department opposed brand‑new mandates generally but would accept the policy if it is narrowly tailored, limited to one device every five years, and subject to existing plan terms and cost‑sharing where medically necessary.

Proponents said the pool of likely users is small and cited conservative cost estimates (low cents per member per month in some studies). Insurers cautioned the fiscal note tied to the bill varied widely and that impacts to small‑group markets and employer plans deserve further actuarial review.

Senators asked for additional guard rails to prevent repeated upgrading of expensive devices every five years and to clarify interactions with existing durable medical equipment rules. Sponsors plan subcommittee work to tighten definitions and cost‑containment provisions.