Comments delivered at HHS listening session for ACA Essential Health Benefits – October 19, 2011

My name is Edward Grandi. I am the executive director of the American Sleep Apnea Association, the only national nonprofit organization for a condition that conservatively affects 18 million adults in the U.S. I am here to advocate in favor of coverage for sleep apnea as an essential benefit under the insurance policies offered by the Affordable Insurance Exchanges.

The association sponsored a letter-writing campaign to the Secretary asking that sleep apnea not be overlooked in the development of ACA. Sadly, the word “sleep” does not appear once in the 2000 pages document that became the law. Sleep an activity that takes up 1/3 of our lives. Subsequently, letters were written asking that sleep apnea be covered under the exchanges. I am here to reiterate that request to the Secretary.

Prior to 1981 the only treatment options available for OSA was a tracheostomy or radical weight loss. It was also thought that the condition affected only middle-aged overweight men.

Epidemiological data collected in 1993 and published in the New England Journal of Medicine provided proof that the condition has a much higher prevalence among adults than originally thought.

The discovery of positive airway pressure therapy in 1981 as an alternative treatment has made it possible to offer an alternative to the surgical options available at the time.

There is an increasing number of studies associating untreated sleep apnea and the sleep deprivation caused by the chronic intermittent hypoxia can and does exacerbates serious life-threatening and medically cost conditions like heart disease, diabetes and depression.

Inclusion of diagnosis and treatment of sleep apnea could in some cases forestall the development or worsening of some of these more serious conditions thereby reducing healthcare utilization.

Cost effective diagnostic and treatment options exist today and others are likely to be developed that will offset the cost of providing these services to those who are currently uninsured.

By addressing this condition, especially if screening is made part of nay health risk assessment would likely result in a net savings to the system.

I thank you for this opportunity to comment and I am available to the Secretary for further information on how treating this condition crosses all ten categories specified in section 1302 of the ACA.