Former Representatives Cathy McMorris Rodgers and Tony Coelho announced in a joint op-ed that Congress should ban the use of quality-adjusted life years (QALYs) and similar measures in federal programs to protect people with disabilities.
"As former members of Congress on different sides of the aisle, we found common ground. We fiercely believe older adults and people with disabilities should not be devalued, especially in our nation's health care system," said McMorris Rodgers, U.S. Representative of Washington's 5th Congressional District (R). "The United States should not embrace health care rationing that de-prioritizes the health and wellness of people living with disabilities, or older adults or even infants. We have a shared interest in barring measures that devalue the lives of older adults and people with disabilities, particularly the quality-adjusted life year, known as the QALY. It is used to justify declining coverage of treatment that doesn't meet a threshold for cost effectiveness based on years that person may live, or whether society deems their quality of life worth living. Preventing discrimination against people with disabilities and chronic illnesses and affirming that every person's life has value is something we can — indeed must — agree on."
According to a 2019 report from the National Council on Disability, QALY-based value assessments incorporate assumptions about living with a disability that may limit access to critical treatments. The report advised policymakers against employing QALYs in federal programs, highlighting that countries using these measures have experienced coverage denials potentially detrimental to U.S. patients with disabilities.
Federal civil-rights enforcement has identified QALY-style rationing as discriminatory. In 1992, the U.S. Department of Health and Human Services withheld approval of Oregon’s proposed Medicaid overhaul until methodologies devaluing people with disabilities were removed, citing concerns over disability rights and mandating protections before any waiver could proceed.
Medicare drug-price negotiations under the Inflation Reduction Act prohibit using evidence that treats extending the lives of older, disabled, or terminally ill individuals as less valuable. According to KFF, QALY-based approaches are not permissible in setting negotiated drug prices, reinforcing nondiscrimination standards within Medicare law.
Coelho chairs the Partnership to Improve Patient Care, a coalition advocating for patient and disability voices in value-assessment discussions. As a former California congressman and primary author of the Americans with Disabilities Act, he has consistently opposed metrics that might restrict care access for vulnerable patients.
After representing Washington’s 5th District from 2005 to 2025 and chairing the House Energy & Commerce Committee, McMorris Rodgers now leads the Cathy McMorris Rodgers Leadership Institute. The institute is dedicated to mentoring future leaders and highlights her role as founder and leader on its website.
