Millions of patients living with disabilities, chronic conditions, and rare diseases are being told their lives aren't worth treating. A discriminatory formula called the QALY is the reason why.
Every day, healthcare decisions are filtered through the Quality-Adjusted Life Year, or QALY. This discriminatory formula reduces a patient's entire existence to a number, calculating that a year of life with a disability is worth less than a year of "perfect" health. It is a cold, calculated way to ration care. And it has no place in our healthcare system.
"This formula stops patients from being seen as people and starts treating them as problems to be solved on a spreadsheet," said Terry Wilcox, Co-Founder and Chief Mission Officer at Patients Rising. "No equation should ever have the power to decide whether a patient's life is worth saving."
On January 8th, during a House Energy and Commerce Health Subcommittee hearing on "Legislative Proposals to Support Patient Access to Medicare Services," Rep. Kat Cammack (R-FL) stood up for every American who has ever been told their life is too expensive to save.
As Rep. Cammack points out, QALYs are building barriers between patients and their doctors. She called the QALY exactly what it is: "a formula that would effectively define the value of someone's care or life." Then, she asked the question that every patient advocate has been waiting for: Should we ban QALYs from all federal programs?
The answer is a resounding yes.
Rep. Cammack has introduced H.R. 3864, the Protecting Health Care for All Patients Act of 2025, alongside Rep. Kevin Hern (OK-01). The legislation is straightforward but powerful. It would ban the use of QALYs and similar discriminatory metrics in coverage and payment decisions across all federal health programs, including Medicare, Medicaid, CHIP, and ACA exchanges. It ensures that no bureaucrat can use a math problem to decide that a senior citizen or a person with a disability is "worth less" than someone else.
This matters because QALYs aren't some abstract policy concept. They are a tool beloved by insurance companies to justify step therapy, formulary exclusions, and coverage denials that keep patients from the treatments their doctors prescribe. For too long, patients with chronic conditions and disabilities have been reduced to lines on a spreadsheet. The QALY doesn't measure the value of a life. It measures how cheaply that life can be managed.
We are living in an era of incredible medical innovation. Treatments that didn't exist a decade ago are giving patients more time with their families, more years in the workforce, more life. Yet the QALY threatens to lock patients out of these breakthroughs by telling them their years don't count the same as everyone else's.
Patient advocates from 26 states urged lawmakers to pass this bill during Patients Rising's 2025 We the Patients Fly-In on Capitol Hill. And now, Rep. Cammack has made the case on the congressional record for all to see.
Every patient deserves to be treated as a whole person, not reduced to a calculation. Congress has the opportunity to make that principle law.
Tell your representative to co-sponsor and pass H.R. 3864, the Protecting Health Care for All Patients Act. Patients living with disabilities and chronic conditions are counting on it.
Ban QALY. Protect patients. Pass H.R. 3864.
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