YOU DID IT: The Medicare Loophole Bill Has PASSED

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Advocacy Blog
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Let’s Take a Look at the Path to Success

We never gave up and we never backed down. For eight years, Fight CRC champions have asked Members of Congress to pass the Removing Barriers to Colorectal Screening Act, nicknamed the “Medicare Loophole” bill! Our hard work has paid off. It’s time to celebrate. The bill has passed! 

Thanks to your hard work, this bill will correct a loophole in Medicare policy that caused beneficiaries to receive unexpected bills for polyp removal during a screening colonoscopy. The correction will happen gradually, with the cost being completely eliminated by 2030.

Here’s a look back at the story of this bill, how it got passed, and the champions behind it.

About the Bill

Fight CRC first began advocating for the bill in 2012 after several Members of Congress responded to advocate stories and wanted to help. The passage of the Affordable Care Act in 2010 enabled seniors on Medicare to get a no-cost screening colonoscopy. However, a loophole in the law meant that if polyps were removed during the procedure, patients could receive an unexpected charge. Over the years, some private insurers removed this charge, but to change Medicare law, Congress needed to act.

In the bill’s earliest days, we met with the Centers for Medicare and Medicaid Services (CMS) to untangle the coding and billing issues and contributed to a Kaiser Foundation study that shed light on the need for a universal policy to address the inconsistency in billing and how it is harmful to patients. Our advocates then started advocating to enlist lawmakers’ support.

For more than eight years, our advocates have included the “Medicare Loophole” bill in our legislative priorities and asked Members of Congress to pass it. During its most recent reintroduction during the 116th Congress in 2019, the bill received unprecedented support from both the House and Senate, and both sides of the political aisle.

Prior to its passage in December 2020, an amendment was added to the bill that will gradually phase out the out-of-pocket cost over time rather than removing it immediately. Patients will be responsible for a decreasing coinsurance with the cost being completely phased out by 2030. 

“Ten years ago the Affordable Care Act was passed. Shortly after we started noticing the negative effect this loophole was having particularly in the senior community. We have been fighting to change this loophole since its inception.  Every congressman we spoke to about this agreed with the fact that it needed to be changed to save lives. Every year we would come a little closer.  It makes me think of the lives we lost because they never got screened for fear of the financial impact. I am extremely happy that this bill has finally passed and  the lives that will be saved because of it.”

Eric Hausmann, Executive Board Member, Advocate

Loophole Bill At a Glance: 2012-2020

House of Representatives

  • Grown from 48 to 344 cosigners (617% increase!)
    • 75% of the House cosponsored the most recent bill  
    • Champions:
      • Rep. Charlie Dent (PA) *retired
      • Rep. Joe Courtney (CT)
      • Rep. Mike Fitzpatrick (PA) *passed away
      • Rep. Donald Payne, Jr. (NJ)
      • Rep. Rodney Davis (IL)
      • Rep. A. Donald McEachin (VA)
      • Rep. David B. McKinley (WV)
      • Rep. Leonard Lance (NJ) *retired

Senate

  • Grown from 15 to 61 cosigners (307% increase)
    • 61% of the Senate cosigned the most recent bill 
    • Champions:
      • Sen. Sherrod Brown (OH)
      • Sen. Roger Wicker (MS)
      • Sen. Ben Cardin (MD)
      • Sen. Susan Collins (ME) 

Fight CRC Relentless Champions

  • A legislative priority every year since 2012
  • Celebrity advocates who spoke at Hill Briefings about the bill:
    • Meghan King Edmonds and Heather Dubrow (Real Housewives of Orange County)
    • Country music singer/songwriter Craig Campbell
    • NASCAR driver Scott Lagasse
    • PGA PROTOUR’s Tom Lehman 
  • Advocates on the Hill grew from 60 to 150 (150% increase) 
  • Virtual advocates grew from 872 to 1,480 (70% increase) 
  • Advocates sent emails to every member of Congress in March 2020
  • Bill passed in December 2020 as part of an end-of-the-year legislative package.

Timeline: 2012-2020

You were RELENTLESS. Advocacy works!

2012

  • “Medicare Loophole” Bill 
    • Reps. Charlie Dent, Donald Payne, Jr., Joe Courtney, and Mike Fitzpatrick introduced H.R. 4120 on March 1, 2012 after working with Fight CRC and American Cancer Society Cancer Action Network (ACS CAN) to introduce legislation narrowly focused on fixing the loophole.
    • “For a Medicare beneficiary on a fixed income, the cost of coinsurance could be the deciding factor of whether to pursue a potentially life-saving screening colonoscopy. Congress must correct current law…”  – U.S. Rep. Charlie Dent (R-PA)
    • H.R. 4120 receives 48 cosponsors 
  • Call-on Congress 
    • 6th annual event 
    • 60 advocates on the Hill
    • 22 states represented

2013

  • “Medicare Loophole” Bill
    • Reintroduced as H.R. 1070 in the 113th Congress
  • Call-on Congress 
    • 80 advocates on the Hill
    • 24 states represented

2014

  • “Medicare Loophole” Bill
    • H.R. 1070 receives 158 cosponsors
    • S. 2348 is introduced by Ohio’s Sen. Sherrod Brown in May 2014
    • S. 2348 receives 15 cosponsors
  • Call-on Congress 
    • 80+ advocates on the Hill
    • 29 states represented
    • 100+ congressional meetings
    • 25,000 signatures on petitions to support H.R. 1070 and S. 2348

2015

  • “Medicare Loophole” Bill
    • Reintroduced as H.R. 1220/S. 624 in the 114th Congress
  • Call-on Congress 
    • 100+ advocates on the Hill
    • 30 states represented
    • 120 congressional meetings
    • 872 virtual advocates
    • 2,750+ emails sent to the Hill

2016

  • “Medicare Loophole” Bill
    • H.R. 1220 receives 289 cosponsors
    • S. 624 receives 39 cosponsors
  • 10th Annual Call-on Congress 
    • 125 advocates on the Hill (48% first-time attendees)
    • 14 junior advocates launch our advocacy program for youth
    • 29 states represented
    • 131 congressional meetings
    • 10,000 emails sent to the Hill

2017

  • “Medicare Loophole” Bill
    • Reintroduced as H.R. 1017/S. 479 in the 115th Congress
  • Call-on Congress 
    • 150+ advocates on the Hill
    • 32 states and 1 territory represented
    • 150+ congressional meetings
    • 9,930 emails to Congress

2018

  • “Medicare Loophole” Bill
    • H.R. 1017 receives 305 cosponsors
    • S. 479 receives 61 cosponsors
    • 15 new cosponsors within two weeks after Fight CRC’s Hill Day
  • Call-on Congress 
    • 154 advocates on the Hill
    • 33 states and 1 territory represented
    • 170 congressional meetings
    • 8,500 petition signatures carried to the Hill

2019

  • “Medicare Loophole” Bill
    • Reintroduced as H.R. 1570/S. 668 in the 116th Congress with unprecedented support
    • 37 new cosponsors within days after Fight CRCs Hill Day
  • Call-on Congress 
    • 150+ advocates on the Hill
    • 33 states represented
    • 156 congressional meetings

2020

  • “Medicare Loophole” Bill
    • H.R. 1570 receives 344 cosponsors
    • S. 668 receives 61 cosponsors
  • Call-on Congress 
    • First-ever all virtual Call-on Congress due to COVID-19
    • 1,480 virtual advocates 
    • 4,056 emails sent for Virtual Hill Day
    • Messages sent to every member of Congress

December 2020 – Bill is Passed!

  • Bill amended to include a gradual phase-out of cost-sharing between now through 2030
  • Bill unanimously passes the House 
  • Bill is included in a large end-of-year government funding and COVID-19 relief bill compiled by the House and Senate leadership
  • Larger legislative bill including the “Medicare Loophole” bill passed by the House and Senate
  • Waiting for President Trump to sign into law 

“Closing this loophole will save a lot of lives because it makes getting screened easier. Systemic changes like this will save a lot of lives and give kids more time with their grandparents and parents.”

— Nancy Roach, Fight CRC Founder

Ready to Join Us?

We definitely want to take time to celebrate this victory, but it is also important to remember that there is still more work to be done! After this win we are more energized than ever going into 2021. We’ve got some big things in store for Call-on Congress this year and we’d love for you to join us. Sign up now to get the inside scoop on all things Call-on Congress 2021.

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