Meeting Amanda & Making a Plan For Medical Diagnostic Equipment

Beto O'Rourke
Oct 15 · 4 min read

In my recent visit to Tuscon, Arizona, I met Amanda Parkman, who has been told by insurance companies over and over again that they will not help her pay to fix her power wheelchair. “As a disabled individual,” she said, she faces “physical barriers” — and doesn’t have the assistance she needs.

Her story communicated to me that insurance alone is often not enough to cover all of the needs of disabled individuals. With Amanda in mind, my plan to guarantee universal, guaranteed, high-quality health care — Medicare for America — will ensure that every American, including individuals with disabilities, receive guaranteed coverage for pre-existing conditions and chronic illness, in addition to long term home and community-based services and supports. Medicare for America provides coverage for wheelchairs and accessories too. I will also ensure that durable medical equipment — and as Amanda notes — critical components such as battery replacements, tires, and general repairs are covered.

Thanks in large part to Amanda’s insight, and the testimony of many Americans with disabilities who have shared their personal experiences and guidance, I understand that insurance alone is not enough to address the health care needs of individuals with disabilities. For many people with limited mobility, a visit to the doctor for a routine check-up or preventative health screening can be impossible if that medical provider does not have accessible diagnostic equipment such as weight scales, imaging equipment, and examination tables.

While existing laws are intended to ensure equal access for people with disabilities, these protections are largely insufficient without broader compliance and ongoing enforcement efforts. Both the Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act require “full and equal access to their health care services and facilities,” but it wasn’t until the passage of provisions included in the Affordable Care Act (ACA) that standards were put in place for the use of accessible Medical Diagnostic Equipment (MDE). Despite this progress, and guidance issued by federal agencies, these requirements lack mechanisms for enforcement.

That’s why I have put forth a plan to expand access to MDE, with steps that include:

  1. Directing federal agencies to include evaluations of compliance with accessible MDE standards and ADA guidance so that health care providers’ services and facilities are accessible for people with disabilities and those with limited mobility;
  2. Tying Medicare reimbursement to the requirement that providers offer high-quality accessible MDE for their patients and train their staff accordingly;
  3. Encouraging partnerships with providers and affiliated organizations, such as the American Medical Association, to share best practices around accessible MDE procurement and training ;
  4. Directing Centers for Medicare and Medicaid (CMS) to provide research and development funding for universal design. Unlike building entrances with stairs, everyone can utilize ramps — we should apply that same philosophy in universal design to health care services and facilities; and
  5. Increasing provider reimbursement rates for medical practices serving low-income communities by moving Medicaid into Medicare for America, ensuring cost is not an obstacle to procurement of accessible MDE.

As Amanda eloquently describes, living a barrier-free life must also include access, accommodations, and safety in air travel for people with disabilities. Airline passengers with disabilities must be assured that their mobility equipment can arrive safely and undamaged. While the FAA Reauthorization Act of 2018 outlines disabled passengers’ legal protections in the Airline Passengers With Disabilities Bill of Rights, neither it nor the Americans with Disabilities Act (ADA) prohibits discrimination against airline passengers with disabilities. However, the Air Carrier Access Act (ACCA) bans discrimination on the basis of disability and applies to all U.S. airlines and flights on foreign carriers that fly into or out of the United States. Beyond eliminating discrimination against disabled passengers, we must do more to ensure compliance with the ACCA so that people with disabilities are treated with courtesy, respect, and dignity and are free to traverse the nation.

That’s why I have also put forth a plan to address barriers to air travel for people with disabilities, to include:

  1. Directing the Department of Transportation (DOT) to diligently enforce the ACCA, investigating reports of violations;
  2. Directing the DOT to ensure that airlines are providing accurate training for airline personnel, and directing them create standards and procedures for employees to comply with the ACCA in an effort to end discrimination and ensure safe storage and transport of wheelchairs and mobility aids;
  3. Advocating for an amendment to the ACCA to include a private right of action, so passengers with disabilities have recourse when they believe their rights have been violated by airlines; and
  4. Holding to account the airline industry, as well as providing incentives, so that that air travel meets or exceeds ADA standards

Whether traveling by plane to Amanda’s beautiful home state of Arizona or making a visit to a local health care provider for a routine exam, I am dedicated to eliminating barriers and ensuring equal access for all Americans with disabilities. Grateful that Amanda and many other Americans with disabilities would shared their personal experiences and guidance with me.

Beto O'Rourke

Written by

El Paso, Texas.

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