Rep. Mike Murphy, of the Indiana House of Representatives, sponsored House Bill 1140, mandating that health insurers in the state provide prosthetic coverage to patients at a level comparable to Medicare. The bill passed March 14, 2008 and was signed into law on March 21.

1) What was involved in creating this bill?
There were two bills, a Senate bill and a House bill, with slightly different content.  

[The House version ended up being chosen and] I was about to take the bill for a vote, [when] the insurance industry came to me and said, “Wait a minute, we can’t have unlimited liability.”

So, I said “Okay, we’ll have a lifetime limit on prosthetic devices, but we’ll make it separate from the regular insurance policy.”  It’s equal to, but separate from, whatever the lifetime limit is in your regular policy. I think this may be the best law in the country for prosthetic device users.

2) What were the key hurdles to getting this bill passed?
One [hurdle] was insurance mandates, which many people hate the idea of. While one mandate may not be that expensive by itself, they pile up.

Another [hurdle] was that, under federal law, self-insured companies cannot be regulated by an insurance mandate for the state. And almost every company of 100 employees or more is self-insured. So an insurance mandate [is] only affecting about 30 percent of the employees in the state. However, I’m hoping the other 70 percent [of employers] will come along because of market pressure to [require prosthetic coverage].

The insurance industry did not oppose the bill, because they didn’t want to be seen as the bad guys. But there were a lot of behind-the-scenes rumors trying to kill the bill indirectly.  I was constantly fighting that.

3) What made you decide to sponsor the Indiana parity bill?
My bill came out of a meeting I had with a constituent of mine, a local firefighter whose son is missing a limb. He was telling me how hard it is to get adequate prosthetic devices for his son.

Until last year, I worked for WellPoint. When I was freed up from that, I started to work on the [state legislature] insurance committee and to look at insurance issues. And for me, it was a matter of fairness. Why should there be a limit on how many legs or arms someone can receive in their lifetime to be a productive member of society?

4) What got through to you when the ACA and the Indiana Amputee Insurance Protection Coalition brought up the issue of prosthetic parity?
It was a concurrent thing that the constituents approached me along with [those groups]. They brought the issue to my attention. They told me that they had been able to pass legislation in six or seven other states, so there was some precedent for doing this, and they asked for my help.

They hired a law firm that does a lot of lobbying in the medical area. At one point, it looked like the bill wasn’t going to pass, and everybody was kind of ready to give up and try again next year. The lobbyists have to deal with this year after year, and they didn’t want to be so aggressive that they’d make somebody mad for next year. I said, “That’s okay, make them mad at me.” I think they were a little bit surprised at my tenacity.

5) What tips can you give O&P professionals interested in persuading legislators in their own states to introduce parity bills?
I would make sure that they have one-on-one meetings with their legislators. Meet them for breakfast at a Cracker Barrel restaurant. I think having legislators meet people who have a prosthesis and have been able to continue [as] productive citizens puts a human side on the story.

We didn’t have any of the manufacturers testify because we didn’t want it to look like they were just out to make more money. It’s better to have people who have to live without an arm or a leg testify and show how well they’re doing—and also what problems and limitations they may have because of lack of insurance.

[It’s good to have] a strategy in how you present your story. Legislation is always more successful when there’s a human element to it, not just statistics.

Interview by Heather Benjamin, assistant editor of the O&P Almanac.