Bill Overview
Title: A bill to amend title XVIII of the Social Security Act to provide coverage for wigs as durable medical equipment under the Medicare program, and for other purposes.
Description: This bill includes medically necessary cranial prostheses (e.g., wigs) as covered durable medical equipment under the Medicare program.
Sponsors: Sen. Blumenthal, Richard [D-CT]
Target Audience
Population: People experiencing hair loss due to medical conditions
Estimated Size: 1000000
- Medicare covers individuals who are 65 or older, or who have certain disabilities, which includes a large demographic of the United States population.
- Providing coverage for wigs will particularly impact individuals who experience hair loss due to medical conditions such as alopecia, chemotherapy for cancer, or other medical treatments.
- Globally, many individuals experience hair loss due to various medical conditions, but this bill specifically targets coverage within the Medicare program in the United States.
Reasoning
- The target population primarily involves older adults or people with disabilities covered under Medicare who experience hair loss due to medical conditions.
- Statistically, this would encompass a subsegment of people undergoing medical treatments such as chemotherapy, or those with conditions like alopecia areata.
- The budget allocation implies a significant portion of affected individuals can receive cranial prostheses, but not all, given the large potential demand.
- Most in need would be those who face substantial social or psychological impacts from hair loss.
Simulated Interviews
Retired Teacher (New York, NY)
Age: 68 | Gender: female
Wellbeing Before Policy: 3
Duration of Impact: 5.0 years
Commonness: 14/20
Statement of Opinion:
- Losing my hair during treatment has been very hard. I feel less like myself.
- A wig would make me feel more confident and comfortable going out.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 3 |
| Year 2 | 5 | 3 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 2 |
| Year 20 | 4 | 1 |
Retired Engineer (Tucson, AZ)
Age: 72 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 12/20
Statement of Opinion:
- It's not just about vanity; hair loss affects my social life and interactions.
- I wouldn't have been able to afford a good quality wig otherwise.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Freelance Writer (Atlanta, GA)
Age: 55 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 8/20
Statement of Opinion:
- My appearance does affect how I feel each day.
- Receiving a wig through Medicare would ease financial stress.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Retired Nurse (Cleveland, OH)
Age: 77 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 0.0 years
Commonness: 20/20
Statement of Opinion:
- I've never had issues with hair loss, but I can see how others would benefit.
- It's a compassionate policy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 9 | 8 |
| Year 5 | 9 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 7 | 7 |
Retired Military (Austin, TX)
Age: 62 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 3.0 years
Commonness: 10/20
Statement of Opinion:
- The hair loss has been a big hit to my identity.
- A wig would restore some of the dignity that cancer has taken.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 4 |
| Year 10 | 4 | 3 |
| Year 20 | 3 | 2 |
Retired Homemaker (Miami, FL)
Age: 80 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 18/20
Statement of Opinion:
- A wig doesn't seem essential to me, but I can understand why others might want it.
- I am satisfied with my appearance despite thinning hair.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 6 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 4 | 4 |
Part-time Sales Assistant (Los Angeles, CA)
Age: 51 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 9/20
Statement of Opinion:
- If wigs were covered, it would be like getting part of my life back.
- It would help boost my morale.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 6 |
| Year 10 | 7 | 5 |
| Year 20 | 6 | 4 |
Retired Police Officer (Seattle, WA)
Age: 65 | Gender: male
Wellbeing Before Policy: 9
Duration of Impact: 0.0 years
Commonness: 16/20
Statement of Opinion:
- Personally, I don't experience hair loss.
- If it helps others feel better about themselves, I'm all for it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 9 | 9 |
| Year 2 | 9 | 9 |
| Year 3 | 9 | 9 |
| Year 5 | 8 | 8 |
| Year 10 | 8 | 8 |
| Year 20 | 7 | 7 |
Retired Librarian (Chicago, IL)
Age: 70 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 11/20
Statement of Opinion:
- I have felt self-conscious about my appearance for a while.
- A new hair piece would greatly improve how I interact socially.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 5 | 3 |
Retired University Professor (Boston, MA)
Age: 67 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 2.0 years
Commonness: 13/20
Statement of Opinion:
- I am bracing for the impact this treatment will have, including losing my hair.
- If Medicare helps with this, it would be one less worry.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 5 | 3 |
| Year 10 | 4 | 3 |
| Year 20 | 3 | 2 |
Cost Estimates
Year 1: $1500000000 (Low: $1000000000, High: $2000000000)
Year 2: $1500000000 (Low: $1000000000, High: $2000000000)
Year 3: $1500000000 (Low: $1000000000, High: $2000000000)
Year 5: $1500000000 (Low: $1000000000, High: $2000000000)
Year 10: $1500000000 (Low: $1000000000, High: $2000000000)
Year 100: $1500000000 (Low: $1000000000, High: $2000000000)
Key Considerations
- The potential increase in administrative costs to process claims and manage new coverage.
- Estimation of demand might surpass initial assessments if more individuals qualify and utilize the benefit.
- The bill may require additional regulatory processes to define what qualifies as a medically necessary cranial prosthesis.