Complementary and Alternative Medicine (CAM), also known as integrative therapies, has gained enormous popularity in the United States. The 2007 National Health Interview Survey revealed that 38 percent of adults and 12 percent of children use integrative therapies such as acupuncture, reiki, massage therapy and yoga. Despite high consumer demand, most of these treatments are not covered by private or public health insurance plans. According to the National Center for Complementary and Alternative Medicine (NCCAM), 83 million adults spend $33.9 billion out-of-pocket on integrative therapies. These costs comprise 11.2 percent of total out-of-pocket expenditures on health care, surpassing expenditures for conventional treatments by primary care physicians. This creates disparity in care along economic lines for consumers who cannot afford to pay for these services out-of-pocket and could benefit from them as a form of wellness and disease prevention.
While the lack of insurance coverage for integrative therapies is a national issue, it makes the most sense to initiate change at the state level since states have historically served as safe and fertile grounds to experiment with incremental changes in health policy. This paper outlines a plan for a grassroots public policy campaign to expand private health insurance coverage of acupuncture in Massachusetts, a state that has historically been a leader in health reform. I chose acupuncture because it is a popular integrative therapy and is already covered by many insurance companies across the nation. There is also extensive evidence that acupuncture is safe and effective, and can save insurers money in the long term, especially for patients with chronic disease. Numerous studies show that acupuncture can effectively treat symptoms from conditions such as migraine, cancer pain,7 fibromyalgia, and chronic pain in elderly patients among others. Acupuncture has also been linked to changes in brain activity;10 however, many policymakers and the general public are not aware of this clinically-based evidence. The scope of the campaign is limited to private insurance because the process of seeking coverage for medical services under Medicare and Medicaid involves a different group of stakeholders. My recommendations are directed toward the Acupuncture and Oriental Medicine Society of Massachusetts (AOMSM), the professional association for acupuncturists in the Commonwealth. (Please see Appendix A for complete definitions of CAM and acupuncture).