Obama's Victory May Result in Full-Scope Chiropractic Coverage

By James D. Edwards, DC

How many times have you heard other chiropractic organizations make the unfounded statement that the National Chiropractic Legal Action Fund’s lawsuits were a waste of money and yielded no real benefit to the profession? I assure you that nothing could be farther from the truth.

For proof, look no further than at the “perfect storm” created by the election of Barack Obama. His proposed health plan and the Trigon lawsuit now perfectly position chiropractic to be included, on a full-scope basis, in a universal insurance plan. 

Have I got your attention? Then read on.
In his campaign, President-elect Obama proposed many things, including universal health care for all Americans:

“Establish a National Health Insurance Exchange with a range of private insurance options as well as a new public plan based on benefits available to members of Congress that will allow individuals and small businesses to buy affordable health coverage.” [Emphasis added]

For a description of President-elect Obama’s healthcare plan, visit his campaign Web site at http://origin.barackobama.com/issues/healthcare.

On the “Frequently Asked Questions” page of the campaign website, Obama’s position is amplified:

“If you do not have insurance you can choose to enroll in the new public plan, which will offer benefits similar to what every federal employee and member of Congress gets.” [Emphasis added]

President-elect Obama’s proposed universal healthcare plan is based on the Federal Employees Health Care Plan (FEHBP). With the Democrats controlling both houses of Congress, there’s a good chance that his healthcare plan could be adopted.

So you are probably thinking, “That’s great, but how many decades will the chiropractic profession have to fight to be included in the Federal Employees Health Benefits Program?”  Well, fasten your seat belt because here is the wonderful news…CHIROPRACTIC IS ALREADY INCLUDED!

That’s right. Solely as a result of ACA’s lawsuit against the national Blue Cross Blue Shield organization, chiropractic is already included in the federal employees health care plan—which is the exact model that Obama has proposed for universal health care.

Chiropractic Inclusion
As a participant and witness to the 2001 events that resulted in chiropractic being added to the federal plan, I’d like to give you a brief overview on how this tremendous victory occurred.

When the ACA sued Trigon Blue Cross Blue Shield, the Blue Cross Blue Shield Association (BC/BSA, the national organization) was also named as a defendant.  That organization indicated in early 2001 that it was interested in settling out of court.

During settlement negotiations, ACA Legal Counsel Tom Daly surprised BC/BSA by proposing that it add chiropractic to its Federal Employee Plan (FEP), the BC/BS-administered component of the FEHBP. After learning that it had that authority, BC/BSA agreed to the proposal. ACA Chairman J. Michael Flynn, DC—after consulting with his fellow ACA Executive Committee members, President James Mertz, DC, and me—quickly closed the deal!

On May 2, 2001, ACA and BC/BSA reached a formal agreement to initiate an ongoing settlement process, and ACA dismissed its claims against BC/BSA. BC/BSA also agreed to address chiropractic coverage and reimbursement problems on a state-by-state basis. Most important, BC/BSA agreed to include a first-ever chiropractic benefit in its FEP!

You are probably asking yourself, “Is the federal employees health care plan really full scope of practice, and if so, what does it include?” You be the judge.  Below are the 2008 chiropractic benefits available to federal employees and members of Congress.

Basic Option
Preferred Provider
(enrollment codes 111 & 112) 
Up to 20 spinal manipulations 
Initial office visit 
Initial set of X-rays 
PT modalities
$0 deductible/$20 co-pay

Standard Option
Preferred Provider
Up to 12 spinal manipulations
Initial office visit 
Initial set of X-rays 
PT modalities  
$0 deductible/ $15 co-pay

Doctors of chiropractic may also be reimbursed for a range of physical therapy and rehabilitative treatments under the federal plan. For a full list, visit www.acatoday.org/pdf/FEPUpdate2008.pdf.

The outstanding coverage of the federal plan has already resulted in over a billion dollars in reimbursement for chiropractic treatments, and the tremendous opportunity the chiropractic profession now has to finally be reimbursed for full-scope services!

Should full-scope chiropractic ultimately be included in universal healthcare coverage, this profession can thank Tom Daly, Dr. Flynn, and the leadership of ACA for having the courage to file the lawsuit…and especially the thousands of NCLAF contributors who made it possible.

Dr. Edwards can be reached at JamesEdwards@JamesEdwards.com.