Why Older Americans Should Have Better Access to Acupuncture

Medicare, the health insurance program for Americans age 65 and older, effectively limits seniors from getting acupuncture relief.

That is why the American Society of Acupuncturists (ASA) and the National Certification Board for Acupuncture and Herbal Medicine (NCBAHM) are working to inform the public and push for change in Congress.

And even if this issue does not seem personal yet, it matters more widely than many people realize.

Licensing rules and professional titles differ across the 50 states, but there are more than 30,000 acupuncture professionals in the United States who help ease pain and improve quality of life. Some patients pay directly, while many others use private insurance to cover treatment.

In Montana, however, people effectively lose acupuncture coverage once they become eligible for Medicare. The reason is that licensed acupuncturists are not included among the Medicare providers authorized to deliver covered acupuncture services.

Medicare says it cannot pay licensed acupuncturists directly. Instead, patients must receive acupuncture from a doctor or another health care provider, such as a nurse practitioner or physician assistant, who also has both a degree in acupuncture or Oriental Medicine from an accredited school and an active acupuncture license in the state where care is provided.

This position clashes with state rules that allow licensed acupuncturists to practice independently without physician supervision. It also sends the message that being a licensed acupuncturist is not enough unless the practitioner is also a doctor, nurse practitioner, or physician assistant.

Medicare currently covers acupuncture only for chronic low back pain, and even then only in narrow circumstances, such as when the pain has no known cause and is not tied to cancer that has spread, infection, inflammation, or surgery.

Those restrictions seem difficult to justify when another federal agency, the U.S. Department of Veterans Affairs, allows licensed acupuncturists to provide care in VA Medical Centers and private practices. The VA has promoted acupuncture as an alternative to opioids and has recognized its role in whole-person health.

Research has also linked acupuncture to improvements in mental health, including reduced anxiety and depression and help with post-traumatic stress disorder, all of which can improve quality of life.

According to the World Health Organization, acupuncture remains the most widely used form of traditional medicine, with its use acknowledged by 113 member states.

U.S. research into acupuncture began in 1976. In 1996, the Food and Drug Administration approved the acupuncture needle as a medical device for use by licensed practitioners. These needles are required to be sterile, nontoxic, and used only once.

The World Health Organization’s 2020 Benchmarks for the Practice of Acupuncture also outlines known risks and ways to prevent or manage them. In practice, the benefits often outweigh the risks, which is why cancer centers, fertility clinics, some hospitals, national sports teams, workers’ compensation claims adjusters, and others recognize acupuncture’s value.

Once patients sign informed consent forms, they can access a relatively low-cost treatment that should be more available, not less, especially at a time when financial pressures are affecting many families. Most acupuncturists in Montana run small businesses and are losing income from services they are qualified to provide.

That raises a simple question: why does Medicare remain so restrictive despite broad global and national acceptance of acupuncture as an evidence-based medical practice?

If the country truly wants to support working Americans as they age, Congress should update Medicare’s language on licensed acupuncturists and expand coverage beyond chronic low back pain.

Supporters are being urged to watch for the ASA-NCBAHM’s Acupuncture for our Seniors Act and speak up for Medicare beneficiaries, because many people may someday rely on the program themselves.