Legislature proposes insurance relief for amputees
Updated: 1/30/2007 10:17 AM
By: Veronica Castelo



In an instant, Frieda Borth's life changed when she was struck by a drunk driver while riding her motorcycle. She lost her leg in that accident.

"You lose the ability to do so many things that you want to do," Borth said.

With the help of a special government-funded program offered by the Texas Department of Assistive and Rehabilitative Services, Borth was able to get a prosthetic leg and work again.

While helping other amputees, she realized she was one of the lucky ones.

"There are so many people who do not have prosthetic coverage. They cannot go back to work," Borth said.

Current Texas state law does not require insurance companies to provide coverage for prostheses, according to Ignacio Madera Jr. of the Texas Coalition for Insurance Services Parity.

Most insurance companies offer disability insurance but cap the benefits so low that the average working family can't afford prosthesis, Madera said.

Amputees gathered at the Capitol to rally support for better insurance coverage for prosthetic limbs.

Michael Durbin lost his leg in a lawn mowing accident. He said he was capped at $3,500. That would only pay for a part of the prosthetic leg he needed.

"I can't just attach that to my body. I need the shell and the socket to make a whole part to be able to make myself work," he said.

Durbin joined Borth and about a dozen other amputees at a rally at the Capitol in support of new Legislation.

Sen. Judith Zaffirini, D-Laredo, and Rep. Pete Gallego, D-Alpine, are sponsoring bills (SB 54 and HB 223) that would require insurance companies to cover as much as the government covers through its Medicare program. Medicare can cover up to 80 percent of prosthesis costs.

"Insurance companies that in many instances have had record
profits over the last year have been unwilling or lacked the incentive to provide full coverage for the amputees," Gallego said.

Jared Wolfe, executive director for the Texas Association of Health Plans, said they do not oppose or support this bill; however, he said they generally oppose mandates. Too many mandates can lead to higher premiums for customers, he said.

Borth said prosthetic devices would help more people get back to work and off government assistance; thereby saving the state money.

"We are missing a limb and want to get on with our lives. And we
need a prosthetic to do that," she said.

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