Congress should protect patient access to oxygen through Medicare reforms

I’ve spent years caring for patients battling severe lung disease as a pulmonologist and sleep specialist, prescribing supplemental oxygen countless times and witnessing the life-changing impact it has on patients and families. I believe anyone who needs oxygen therapy at home should be able to access it—but this, sadly, is not the case for all respiratory patients under Medicare’s current benefit.

Long before I became an advocate for oxygen patients and gained years of clinical experience, I was a daughter watching my father struggle to breathe while my mother, a retired nurse, served as his primary caregiver. My family’s experience shaped my support for improving access to supplemental oxygen just as much as my professional one.

My father had advanced Chronic Obstructive Pulmonary Disease (COPD) and bronchiectasis that had already progressed significantly by the time he came under the care of a pulmonary specialist. His need for oxygen steadily increased, and what started as occasional use became a constant companion, despite his initial reluctance.

Supplemental oxygen became more than just a means of helping him breathe and sleep. It was what allowed him to continue living.

People who have never relied on supplemental oxygen may not realize how much effort it takes. Leaving the home can require hours of preparation. Getting to a doctor’s appointment can be a logistical challenge. Even completing simple daily activities can take up enormous amounts of energy. I remember watching him pace himself, stopping to catch his breath after only a short walk. His oxygen needs increased from just a couple of liters per minute (LPM) to eventually 10 LPM—the maximum amount for oxygen concentrators—as his disease progressed.

My father fought hard to remain independent up until the day he passed away. He didn’t want to be confined to a wheelchair. He wanted to make his own meals, shave before his appointments, and maintain a sense of normalcy. Supplemental oxygen therapy made that possible.

In my professional role, I’ve had to jump through insurance hoops and excessive medical paperwork to fight for my patients to get portable concentrators so they can remain connected to their families and preserve their quality of life. This should not be today’s standard of practice.

When administrative requirements destabilize reimbursement systems, providers and patients are the ones who are most affected. Suppliers leave the market. Services become harder to obtain. Patients face disruptions in care that result in clinical decline.

That’s why I support the Supplemental Oxygen Access Reform (SOAR) Act (S. 1406/H.R. 2902). At its core, this legislation is about protecting consistent access to medically necessary respiratory care for Medicare beneficiaries who depend on oxygen equipment to sustain their livelihoods. An important provision of the SOAR Act would strengthen Medicare reimbursement for oxygen services and ensure patients and families have support after an oxygen prescription is written.

I can tell you that oxygen therapy isn’t as simple as handing someone a machine and sending them home. Questions come up. Patients’ conditions change. Something isn’t working right. Respiratory therapists help patients understand their treatment and stay as active as possible—but we need Congress to improve the system so patients can actually access the clinical expertise and support we provide.

Importantly, the SOAR Act would establish important protections for oxygen patients, recognizing that not every patient needs the same type of oxygen or equipment. The goal should be to help patients access the option that best fits their condition—particularly those who would benefit from portable, high-flow oxygen.

Most families don’t have a nurse and a pulmonologist sitting at the kitchen table. They deserve a system that supports them, not one that creates additional challenges. Patients deserve reliable access to oxygen care at home, and Congress has an opportunity to make that happen with the SOAR Act.

Alison Kole is a Millington resident and a board-certified medical doctor in Sleep Medicine, Pulmonology, and Critical Care who has been serving the New Jersey area for over 10 years. She is also the vice chair of the American Academy of Sleep Medicine (AASM) Advocacy Committee and is the creator and host of the Sleep Is My Waking Passion podcast.