Supplemental oxygen users have long been burdened by limited access to lifesaving treatment. In the early 2000s, Medicare introduced competitive bidding to lower costs and promote competition among durable medical equipment (DME) companies. Instead, supplemental oxygen, especially liquid oxygen, became a hot commodity.

Medicare claims from 2010 and 2020 show use of liquid oxygen dropped by 80% even though respiratory disease patterns remain unchanged, according to the American Association of Respiratory Care. A reason for this is that companies are changing out liquid oxygen tanks for compressed oxygen, which is cheaper, heavier and doesn’t last as long.

For people like Elaine, who has used liquid oxygen for 17 years to help with her emphysema, this is a travesty. “My liquid oxygen tank used to last about six hours and allowed me to teach aerobics classes, go to the grocery store, and lead a somewhat normal life,” she said. “When they suddenly replaced it with compressed oxygen, I panicked! The tank is much heavier, and as a 77-year-old woman who lives alone I cannot handle lugging it back and forth. Plus, it only lasts about an hour which means I can barely leave my house without the concern of running out of oxygen. It is causing me major anxiety.”

Elaine is not alone. Caroline is another formerly active patient who, without portable liquid oxygen, has been sentenced to the confines of her home. She now goes through four refillable tanks in three hours, and that is if she is just being sedentary. “Before I lost my liquid oxygen, I went to pulmonary rehab regularly, attended church each Sunday, did all my own shopping and could get to and from doctor's appointments on my own. Now I need assistance with everything, and I am unable to participate in outside activities,” Caroline explained.

Joan’s story is pretty much the same. After being on an unobtrusive liquid oxygen unit since 2009, in 2020 her provider said they would no longer supply her with liquid oxygen. Instead, they insisted she switch to a POC that was 19 pounds, required a $100 cover so it didn’t get wet and a backup battery for another $350."After all that extra cost, the manual reads ‘If unit fails to operate properly, find another source of oxygen,’” she said. Now Joan suffers anxiety attacks every time she thinks about leaving the house.

But there is hope. On February 28, Senators Cassidy, Warner and Klobuchar introduced their bipartisan legislation, the Supplemental Oxygen Access Reform (SOAR) Act of 2024. An identical, bipartisan bill is expected soon in the House of Representatives. The SOAR Act would remove oxygen from Medicare competitive bidding and provide additional protections to the 1.5 million people in the US who need supplemental oxygen. For too long, patients who require supplemental oxygen have not had access to oxygen appropriate for their medical and quality of life needs, especially individuals who require liquid oxygen. “Medicare can be a great program, but it has major faults, and the difficulty getting supplies for oxygen patients shows this,” Joan continued.

“Oxygen patients number in the thousands but 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 supplies. 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.”

Join us in advocating for supplemental oxygen reform to ensure equitable access and quality care for all by taking our action alert. To learn more about the four proposed pillars of oxygen reform and learn more about oxygen therapy at Lung.org/oxygen.

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