NEW YORK - None of us wants to ponder what life would be like if we lost a limb; but a new change in policy for the New York State of Health marketplace just made life more manageable for thousands.

At issue was how often and how many prosthetic limbs could be replaced for New Yorkers who rely on what is commonly known as "Obamacare." Heidi Siegfried, project director for New Yorkers for Accessible Health Coverage, said New Yorkers now will be covered if they outgrow prosthetic limbs or if the limbs simply wear out over time.

"So, this means that people will not have to pay out of pocket anywhere from $5,000 to $80,000 to replace a limb," she said, "which they do need replacement, like, every three to five years."

Siegfried said New York lawmakers also are debating a long-term fix this session that would make coverage for these prosthetic devices a matter of law in New York.

Solomon Wolde is a Type 1 diabetic from the Bronx who has two prosthetic devices from leg amputations. The loss of a kidney qualified him for Medicaid and, as a result, his limb replacements are covered. Still, he said he is concerned about other uninsured fellow New Yorkers who need state lawmakers to take action.

"If you don't have insurance, that means I couldn't leave my house. I couldn't go to the hospital or to visit a friend. I cannot do anything," he said. "That means it's very important for people who lose their limbs, so they have to fix the policy."

Siegfried said the replacement issue is important, considering the number of New Yorkers who lose a limb each year.

"In New York in 2012 there were hundreds of people getting upper-limb amputations and thousands of people that needed below-the-knee and above-the-knee amputations each year," she said, "and then, of course, they are going to need repair and replacement."

Siegfried said this is one positive sign as to how Obamacare rules can be improved to meet the changing needs and gaps in coverage for New Yorkers.


get more stories like this via email

FARGO, N.D. - People with Down syndrome are having a bigger impact on society, and their advocates in the Dakota region say it's time for the public to take notice.

October is Down Syndrome Awareness Month. It's widely known that people born with this condition have an extra chromosome that affects their development, but some say there's more to it.

The New Directions Down Syndrome Association connects parents in a four-state region, including parts of North Dakota. Brandon Tilus, president of its board of directors, said he feels public perception is being outdated by the lives many with Down syndrome are carving out for themselves.

"People with Down syndrome born today have a really good chance of living a life where they're independent, that they get married, that they do all of these things that we expect all individuals to do," he said.

He credited early-intervention programs and advancements in therapy for establishing better outcomes. However, he said strong government funding still is needed to ensure more families have access to these services. According to the Centers for Disease Control and Prevention, Down syndrome occurs in about one in every 700 births.

Tilus said another way to overcome any stigma is for people to make others with Down syndrome feel more at ease in their interactions. He also advises that some ways of communicating should be avoided.

"'I use my hands more to talk to them, because I'm not sure they're going to understand me.' And, those types of things - sort of, coming into an interaction with those individuals with those preconceived notions - I think can make it a little bit more difficult," he said.

Tilus, whose 6-year-old daughter was born with the condition, said the best thing to do is treat a person with Down syndrome like anybody else. All they may need is a little extra time to respond, and be given the opportunity to take the lead in a conversation, to feel comfortable.

SPRINGFIELD, Ill. -- As businesses across Illinois and the nation work to fill open positions, advocates for people with disabilities say they should take a more inclusive approach.

According to federal data, the jobless rate for people with disabilities is 11.5%, compared with slightly more than 5% for the rest of the population.

Kim Mercer-Schleider, director of the Illinois Developmental Disabilities Council, said with workforce shortages across many industries, there is no reason for people with disabilities to be underemployed.

"I would ask for employers to be open to taking a look at, what positions do you need to have filled?" Mercer-Schleider suggested. "How can they be broken up or looked at differently, that capitalizes on somebody's skill set?"

She noted it is important to acknowledge some people might need accommodations in some areas, but can really thrive in others. October is National Disability Employment Awareness Month, and she pointed out it is the perfect time to reflect on how to make hiring practices more inclusive.

Mercer-Schleider added it is also important to make sure the hiring process itself is accessible. She observed some online applications are not compatible with screen readers, for instance.

"Are your materials accessible? Can they be accessed with assistive technology, etc.? Are you opening up the door wide enough?" Mercer-Schleider outlined.

She emphasized the pandemic also has shown more flexible work is possible, for instance, working from home is a viable option for people who may have mobility issues or lack transportation. She hopes employers will embrace it as an option for accessibility beyond the COVID crisis.

NEW YORK -- Disability advocates and other groups are suing the federal government over the Social Security Administration's practices during the pandemic, including shuttering its local offices.

The challenge was filed on behalf of five New Yorkers who utilize Supplemental Security Income (SSI), which helps low-income older adults and people with disabilities.

In March 2020, Social Security, which administers SSI, closed all of its offices, making it difficult for recipients to report any financial changes. Six months later, the agency started to send notices to thousands of people telling them their benefits were going to be reduced due to overpayment, without giving them a meaningful chance to contest it.

Kate Lang, senior staff attorney for Justice in Aging, which represents the plaintiffs, said the office closure left many vulnerable people in the dark.

"People have difficulty communicating with Social Security and saying, 'This is a mistake. I'm still eligible for these benefits. I shouldn't be cut off,'" Lang explained. "We think that Social Security needs to recognize that the pandemic continues."

The federal government has 60 days from filing to respond to the lawsuit. Other organizations involved in the case include New York Legal Assistance Group and Arnold & Porter.

The suit also raised concerns over Social Security's streamlined waiver process, implemented in August 2020, which was meant to forgive financial penalties for overpayment during the first few months of the pandemic.

Danielle Tarantolo, director of the special litigation unit at New York Legal Assistance Group, said the waiver failed to address the pandemic-related SSI issues.

"Our clients tried repeatedly to take advantage of this streamlined process and get a quick waiver so that they could maintain their full benefits and over and over again, they were unsuccessful," Tarantolo recounted.

Representatives for the New York SSI recipients said they hope the lawsuit leads to Social Security revamping the waiver process to make sure that everyone who deserves one can get it. Social Security offices around the country remain closed to the public, except for emergency situations.