Bipartisan Colorado Bill Would Require Insurance to Cover Prosthetics For Sports, Recreation

Mar 29, 2023 |

Republished with permission from Colorado Newsline, written by Sara Wilson

State Rep. David OrtizColorado lawmakers want to make it easier for people who use prosthetics to participate in sports and other active recreation by requiring insurance to cover additional prosthetics for those activities.

“We have the technology and the means to allow our kids to access the outdoors and participate in sports in an equitable way to all of their able-bodied counterparts,” state Rep. David Ortiz, a Denver Democrat who is sponsoring the legislation, said during a Tuesday committee hearing. Ortiz is the first Colorado lawmaker to use a wheelchair and is an advocate for disability rights.

Right now, insurance covers basic, everyday prosthetics for people with limb loss. It doesn’t cover so-called activity prosthetics — such as blades designed for running, specialized feet for snow sports or hands made to grip a golf club — because they aren’t deemed medically necessary.

Those prosthetics cost thousands of dollars, sometimes even upward of $50,000, and aren’t accessible to most Coloradans who would benefit from them.

House Bill 23-1136 would require that insurance plans cover those specialized prosthetics that allow people to recreate and lead an active lifestyle. It passed its first committee hearing unanimously on Tuesday and now heads to the Appropriations Committee.

The bipartisan bill is sponsored by Ortiz, Rep. Anthony Hartsook, a Parker Republican, Sen. Faith Winter, a Westminster Democrat, and Sen. Larry Liston, a Colorado Springs Republican.

As introduced, the bill would have applied to people 26 years old and younger, but that age limitation was amended out during committee.

Maine was the first state to pass a similar law last year, and Colorado joins a handful of other states looking at legislation this year on the issue.

David Schlicht was an avid skier bound for the Olympics when he got in an accident during training that resulted in the amputation of his right foot.

Schlicht was able to get back on the slopes when he got a high tech BioDapt Versa Fit foot, which is uniquely designed to absorb shock and impact during sports. He was only able to get that foot, however, through a grant as his insurance would not cover it.

“With this new sports foot, David went from barely getting down a ski slope in his everyday prosthetic to skiing expertly as he had before his accident,” his mother, Suzanne Schlicht, said. “Had it not been for this grant — which I only learned about due to our deep connections in the ski industry — David would not be participating in sports alongside his peers and he would be instead watching from the sidelines.”

While these specialized prosthetics let people safely hike, run, swim, ski and more, they can be even more important in the mental and emotional well-being for people with limb loss by helping them return to passions with their able-bodied peers, rather than leading a sedentary and restricted lifestyle.

“My accident was very mentally challenging. There were days where I could hardly imagine how I could be myself again. Getting back outdoors into high physical activity was the key to my recovery,” David said.

Experts say that activity prosthetics reduce the risk of disease down the road because it allows people with limb loss to remain active. Everyday prosthetics are not designed for more than casual movement. If someone regularly runs on an everyday prosthetic foot, for example, it could lead to injury and greatly reduce the lifespan of the prosthetic.

David was lucky to get a grant to cover his new foot and that he successfully received it. Often, the charities that administer those types of grants don’t have the capacity or efficiency to follow through.

Kristine McMahon said her son Braden, whose left leg was amputated when he was 11 months old, was promised a running blade. After 18 months, however, they have yet to see the prosthetic that would allow Braden to run, jump and play with more stability.

If insurance covered an activity prosthetic, people would not have to rely on charity and grants.

“Having the ability to gain access to recreational devices through our insurance company would guarantee the ability for children like Braden to have a quality of life as any able bodied person,” McMahon said. “It is medically necessary for children to be active and healthy.”