AMTA: Supporting Massage Therapists for the Affordable Care Act (or Not?)

The Affordable Care Act goes into effect on January 1, 2014. This stands to have a major impact on the ability of massage therapists to be reimbursed by insurance. The 1300+ page document includes language prohibiting discrimination against licensed integrative health care practitioners.

Diana Thompson, well-known educator, author, long-time AMTA member and past president of the Massage Therapy Foundation, recently shared with me a letter she sent to the BOD of AMTA, expressing her concerns that the organization is not supporting the movement of massage therapy into the mainstream as a health care choice. In the letter, Thompson went so far as to call out AMTA for not operating according to their own bylaws, which include the mandates that the organization is, among other things, to

(D.) Promote legislation that supports and upholds, and oppose legislation that harms
and damages, the massage profession;

(E.) Protect and preserve the rights of its members;

(H.) To advocate the rights and interests of persons seeking massage therapy as
health care;

Thompson was moved to write the letter to the BOD after a recent meeting of representatives of CAM professions, held at Bastyr University in Seattle. After the meeting, the purpose of which was to discuss the ACA, Cynthia Price, PhD, LMP, who attended on behalf of the Academic Consortium for Complimentary and Alternative Health Care stated in her report to Executive Director John Weeks:

I was very pleased to attend the Region X/ACA meeting on Monday held at Bastyr this week.  It was a very informative meeting and a nice first step to bring clinicians from different CAM and Medical disciplines into one room together who all want to be better informed and care deeply about this topic.   Deborah Senn did an excellent introductory presentation on the ACA and the current concerns regarding the language that may put CAM providers at risk for inclusion/coverage.  With the exception of the massage representative from the AMTA, all the clinical speakers were excellent and very supportive of the ACA and interested in doing everything possible to support coverage by practitioners within their discipline.  These clinicians expressed similar concerns regarding the ACA and how it may or may not affect CAM services.  There were also clinical examples provided about how the ACA may positively impact certain disciplines, particularly NDs who provide primary care… On a side note, I am very concerned about the position of the AMTA…”

Winona Bontrager, President of the Board of AMTA, responded with a letter to Thompson that stated:

“We have spoken with some other people who attended the recent HHS meeting.  Some of those individuals were there representing other groups and of course our chapter members, and none of them came away from that meeting with the understandings you put forward.  We have no idea how Cynthia Price arrived at the statement she has made to you.”

Thompson also stated in her letter to the BOD that Price had specifically asked that Chris Studebaker, AMTA’s Director of Government and Industry Relations and the person who was representing AMTA at the invitation-only meeting, not be invited to attend future meetings, and that others besides AMTA should be invited to better ensure accurate and professional representation of the interests of massage therapists.

These are serious accusations. AMTA’s response is that Studebaker’s statements at the meeting were conveying the results of AMTA’s last member survey, which revealed that about 50% of the membership has no interest in third-party reimbursement. Bontrager, speaking on behalf of the BOD, stated that Studebaker is being unfairly blamed for things he did not say. Thompson states that she stands by her accusations.

Thompson also stated that she spoke to AMTA leaders about the need for support and action regarding the ACA on at least a couple of other occasions, notably at the last AMTA National Convention in Raleigh, NC and again at the IMTRC held in Boston earlier this year, and that both times was given “wait and see” and “we’re not ready” responses by the leadership.

This entire brouhaha brings to light several issues and bigger questions. First, lest there be any confusion here, even if the ACA results in every massage therapist in the country being eligible for third-party reimbursement, no one is going to be forced to accept insurance. Anyone who wants to keep operating a cash-only practice will be able to do so.

Second, if 50% of AMTA’s membership doesn’t want to participate with insurance clients, that means there is also 50% that does. Since the 50% who don’t want to are not going to be forced to participate, what about representation for the half of the members who do want to?

Third, I must agree with Thompson that this is not the time to “wait and see.” This is the time to be proactive. I will point out the position statements approved by this organization that clearly demonstrate the health benefits of massage therapy! If we can make that more available to the public who have insurance that would pay for it, shouldn’t we be doing that?

Diana Thompson is a long-standing and dedicated member of AMTA. She was instrumental in gaining the right for massage therapists to file insurance in the state of Washington, where 90% of AMTA members do bill insurance. I don’t believe she is on a witch-hunt at AMTA. I believe it came from genuine concern that a major voice that should be speaking out for us is not doing so. Her letter cited the research from AMTA’s own 2009 consumer survey that showed that 97% of massage recipients believe that massage should be considered as health care.

The field of massage therapy has been experiencing growing pains for quite some time. There are concerted and combined efforts going on right now to raise the quality of education, to raise the quality of teaching and education, and to raise the image of massage in the eyes of the public. AMTA has made many efforts in the past on behalf of the membership, and I urge them not to drop the ball this time.

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