Support the SOAR Act to Restore Access to Supplemental Oxygen Therapy

By Erika Sward, Assistant Vice President of National Advocacy, American Lung Association; President, Coalition for Health Funding

Joan, who is living with chronic obstructive pulmonary disease (COPD), was first prescribed a lightweight, portable liquid oxygen device in 2009 to help her breathe easier. The device was “unobtrusive and I went everywhere with it,” she said, including to her job.

Today, Joan’s life is dramatically different. As a retired Medicare beneficiary, she is now forced to rely on a larger compressed air device, with limited oxygen capacity and flow, which has essentially left her homebound.

For more than a decade, supplemental oxygen therapy has been part of the Centers for Medicare and Medicaid’s (CMS) competitive bidding process, resulting in significant decreases in reimbursement for oxygen equipment and supplies. Liquid oxygen, while lighter and portable with greater capacity and flow, is more expensive. Compressed oxygen is cheaper, but supplied in larger tanks; typically, steel or aluminum, three-foot tall cylinders, often requiring a cart to transport. Portable compressed air is available, but these oxygen concentrators (known as POCs) do not provide enough oxygen flow for individuals with more significant needs.

Liquid oxygen use dropped by 80% between 2010 and 2020, according to the American Association of Respiratory Care, despite respiratory disease patterns remaining unchanged. As a result, there are fewer liquid oxygen manufacturers.

More than 1.5 million Americans rely on oxygen for short or long periods of time. These include people living with advanced COPD, pulmonary fibrosis, cystic fibrosis, pulmonary arterial hypertension pneumonia and other and conditions. Supplemental oxygen does not cure lung disease; however, it can improve symptoms, including shortness of breath, fatigue and organ function.

Unfortunately, many individuals utilizing compressed oxygen therapy have difficulty exercising or performing routine activities outside the home because they need access to liquid oxygen, which gives them higher flow.

“I find it hard to leave the house,” said Joan. “This is a terrible situation. Am I to be a prisoner of my disease? Many patients cannot physically deal with tanks or heavy portables or need higher liter flow; I know I am not the only one.”

Fortunately, there is hope. On February 28, U.S. Sens. Bill Cassidy (R-LA), Mark Warner (D-VA) and Amy Klobucher (D-MN) introduced the Supplemental Oxygen Access Reform (SOAR) Act of 2024 (S. 3821). Plans are underway to introduce an identical bipartisan bill in the House of Representatives.

The SOAR Act would:

  • Remove oxygen from Medicare competitive bidding and ensure access to liquid oxygen for those for whom it is prescribed

  • Add payment for respiratory therapy services to ensure individuals who use supplemental oxygen have the necessary training on using oxygen

  • Establish an oxygen users’ bill of rights

  • Create national standardized, simplified document requirements for supplemental oxygen claims

The American Lung Association is among 30 organizations actively advocating on behalf of these legislative changes.

American Lung Association President and CEO Harold Wimmer calls the legislation “vital to people living in the U.S. who rely on supplemental oxygen for their health and overall well-being.

“Thanks to advancements in research and treatment, most people living with severe lung disease can live active lives,” said Wimmer. “Unfortunately, too many people face challenges in getting the right type and levels of oxygen required to do day-to-day activities.”

Joan agrees that a change is necessary. She says despite the high number of patients receiving supplemental oxygen, “we rarely see them in stores, out and about or in restaurants. Why? Because many patients cannot physically deal with heavy tanks or need higher liter flow.”

CMS must increase the reimbursement for oxygen,” she continued. “We want our freedom back; we need to be with our families, friends and enjoy life. We need to have the proper equipment to be able to leave our houses in confidence.”

Please join the Lung Association in advocating for the SOAR Act to ensure equitable access and quality care for all by taking our action alert.

Learn more about the four proposed pillars of oxygen reform and oxygen therapy at Lung.org/oxygen.

 

Noah Hammes