When I was just 22 years old, I was a passenger in a motorcycle crash that left me paralyzed from the chest down. Yet ever since, I’ve been able to live an independent, fulfilling life, thanks to modern medicine and medical devices.
But soon, a federal agency could strip away my access to some of those essential tools — unless White House officials or Congress intervenes.
Last year, the Centers for Medicare and Medicaid Services finalized a plan to add urological and ostomy supplies, including the catheters I use daily to drain my bladder, to its “competitive bidding” program. Medicare officials will select just a handful of medical supply companies that, starting in 2028, sell and deliver these products to Medicare beneficiaries across the country.
Their goal is to reduce Medicare spending by routing nearly all Medicare purchases of certain products through just a few companies. To win one of those gigantic contracts, companies will offer the government lower rates. And that, in turn, should reduce overall Medicare spending.
At least in theory.
In reality, the program will disrupt patients’ access to many specialized products. And over time, it’ll stifle research into new medical devices and products that improve patients’ lives and prevent costly complications.
The White House and Congress could do right by both patients and taxpayers by telling Medicare officials to scrap this plan.
Millions of people have spinal cord injuries, spina bifida, multiple sclerosis, Parkinson’s disease, prostate problems, and other conditions that prevent them from using the bathroom normally. As a result, they rely on catheters and ostomy bags to drain, collect, and safely dispose of their bodily waste.
Improvements to these technologies have vastly enhanced patients’ quality of life.
Consider catheters. Several decades ago, patients generally relied on basic PVC catheters that they had to lubricate themselves. Today, many of us use hydrophilic catheters that come precoated, which makes them easier to use, more comfortable, and far less likely to cause catheter-associated urinary tract infections that can lead to expensive hospitalizations.
Or consider ostomy bags. Older products often irritated patients’ skin. They frequently leaked. And they required frequent changes.
Newer products have solved many of those problems. They’re more customized, discreet, comfortable, and technologically advanced, which enables patients to live their lives without worrying about an embarrassing odor or serious medical complication.
The CMS’s new bidding system could cut these suppliers, and their specialized products, out of the market entirely. Medicare plans to contract with only 10 hydrophilic urinary catheter suppliers and six ostomy suppliers nationwide, down from the hundreds that currently provide products.
That would be a major blow to specialty suppliers. Without Medicare reimbursements, it could be nearly impossible for mom-and-pop or regional operations to stay in business. A recent survey found that nearly half of suppliers anticipate significant challenges to maintaining their businesses, with many warning they could be forced to scale back operations or close entirely.
If suppliers close or reduce offerings, patients across the country, regardless of whether they’re on Medicare or private insurance, could lose access to the products they currently depend on.
The long-term consequences are just as concerning. By shrinking the market for specialty products, the competitive bidding program will likely reduce companies‘ incentive to invent new devices and products. One study found that when Medicare cut reimbursement for certain medical devices in the past, it resulted in a 25% decline in new product introductions and a decrease in patent filings by 75%.
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The CMS rightly wants to reduce financial waste. But limiting patients’ access to the supplies they need to remove bodily waste won’t accomplish that goal. In fact, it could lead to more infections and hospitalizations, which could increase overall Medicare spending.
Medicare officials are putting people’s lives on the line — including my own. Congress and the White House can protect patients, and taxpayers, by urging those officials to reconsider.
Jesi Stracham is a wheelchair athlete, advocate, and sales representative for U-Med who has been paralyzed from the chest down since a 2015 motorcycle crash.