Bill Overview
Title: Medicare Demonstration of Coverage for Low Vision Devices Act of 2022
Description: 2022 This bill requires the Centers for Medicare & Medicaid Services (CMS) to carry out a demonstration project to evaluate the fiscal impact of covering low-vision devices under Medicare in the same manner as Medicare coverage is provided for durable medical equipment. The bill defines low-vision device to mean a physician-prescribed device that magnifies, enhances, or otherwise augments or interprets visual images; the term does not include ordinary eyeglasses or contact lenses. The bill appropriates $2.5 million for FY2022 and each of the next four fiscal years for the CMS to carry out the project.
Sponsors: Rep. Maloney, Carolyn B. [D-NY-12]
Target Audience
Population: People with low vision requiring specialty devices for enhanced sight
Estimated Size: 2500000
- Low vision primarily affects the elderly, who are a significant segment of the population.
- Visual impairment data indicates that globally around 2.2 billion people have a vision impairment, but not all of these are categorized as 'low vision'.
- Low-vision devices are most relevant to people with vision impairment not correctable by standard glasses or contacts.
- In the US, around 12 million people aged 40 and older have vision impairment, including 1 million who are blind, 3 million who have vision impairment after correction, and 8 million who have vision impairment due to uncorrected refractive error.
- The demonstration project's focus is to benefit those with low vision, particularly within Medicare eligible citizens.
- Medicare primarily serves the 65 and older population, of which there are approximately 54 million people in the US.
Reasoning
- The policy aims to support individuals with low vision, particularly those within the Medicare eligible age group and other eligible categories, though the limited budget constrains the number of beneficiaries who can be served.
- Low vision affects a significant number of people over the age of 65, aligning well with the Medicare demographic.
- Given the allocation of funds, the primary beneficiaries would likely include those with severe visual impairments requiring more costly devices that exceed standard eyewear solutions.
- Since the policy's budget is relatively modest, it will likely have a low to medium impact for the individuals who are selected to participate, potentially improving their quality of life significantly while providing limited reach across the overall eligible population.
- The interviews consider a range of individuals, from those directly impacted to those not affected, to get a balanced view of the policy's efficacy and limitations.
Simulated Interviews
Retired teacher (Florida)
Age: 70 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 12/20
Statement of Opinion:
- The policy would greatly improve my ability to read and write.
- I'm concerned that not everyone who needs devices will get them due to budget limits.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 3 |
| Year 3 | 7 | 3 |
| Year 5 | 8 | 2 |
| Year 10 | 8 | 2 |
| Year 20 | 6 | 1 |
Retired nurse (California)
Age: 78 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 8/20
Statement of Opinion:
- I think the policy would provide necessary support for people like me.
- I'm hopeful that more funding could be secured in the future.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 6 | 2 |
| Year 20 | 5 | 2 |
Graphic designer (New York)
Age: 61 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 14/20
Statement of Opinion:
- I might not qualify for the demonstration as I'm not yet 65.
- The policy could help others with more severe needs.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 5 | 4 |
Retired librarian (Texas)
Age: 86 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 5.0 years
Commonness: 10/20
Statement of Opinion:
- Low vision devices could help me a lot.
- Access to these technologies seems critical for my independence.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 6 | 2 |
| Year 3 | 7 | 2 |
| Year 5 | 7 | 1 |
| Year 10 | 7 | 1 |
| Year 20 | 6 | 1 |
IT specialist (Ohio)
Age: 52 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 16/20
Statement of Opinion:
- The demonstration doesn't seem to apply to me right now.
- I appreciate the focus on specific needs, though.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 6 |
Retired accountant (Michigan)
Age: 72 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 2.0 years
Commonness: 9/20
Statement of Opinion:
- I fear I'll be overlooked due to the project's size.
- Being able to see better would help me regain some independence.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 5 | 3 |
| Year 5 | 5 | 2 |
| Year 10 | 4 | 2 |
| Year 20 | 3 | 1 |
Retired engineer (New Jersey)
Age: 65 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 11/20
Statement of Opinion:
- This policy could help improve my quality of life.
- It's a step in the right direction, despite budget constraints.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 2 |
Retired professor (Illinois)
Age: 80 | Gender: female
Wellbeing Before Policy: 2
Duration of Impact: 4.0 years
Commonness: 8/20
Statement of Opinion:
- The availability of these devices would significantly improve my daily life.
- I hope the program can be extended to reach everyone in need.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 2 |
| Year 2 | 5 | 2 |
| Year 3 | 5 | 2 |
| Year 5 | 6 | 1 |
| Year 10 | 5 | 1 |
| Year 20 | 4 | 1 |
Stay-at-home spouse (Georgia)
Age: 55 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 13/20
Statement of Opinion:
- This policy won't directly affect me right now.
- It's important work that could mature into broader coverage.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 5 |
| Year 5 | 5 | 4 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Retired mechanic (Arizona)
Age: 73 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 3.0 years
Commonness: 12/20
Statement of Opinion:
- The project would greatly help in maintaining my independence.
- I worry about the limited scope missing some individuals.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 2 |
| Year 10 | 5 | 2 |
| Year 20 | 4 | 2 |
Cost Estimates
Year 1: $2500000 (Low: $2500000, High: $2500000)
Year 2: $2500000 (Low: $2500000, High: $2500000)
Year 3: $2500000 (Low: $2500000, High: $2500000)
Year 5: $2500000 (Low: $2500000, High: $2500000)
Year 10: $2500000 (Low: $2500000, High: $2500000)
Year 100: $2500000 (Low: $2500000, High: $2500000)
Key Considerations
- The demonstration project has a fixed budget for five years, limiting immediate financial risk.
- Final outcomes may influence broader Medicare policy on low-vision device coverage.
- Potential savings or cost increases depend on demonstration findings and subsequent policy changes.
- The target population is primarily Medicare recipients over 65 with low vision.
- Limited impact on GDP and taxes due to the project's modest scale