Outdated Insurance Rules Are Putting Patients With COPD at Risk

A new white paper from the COPD Action Alliance exposes major gaps in how the U.S. health system treats people living with chronic obstructive pulmonary disease (COPD). Despite being one of the nation’s leading causes of death, millions of Americans remain undiagnosed or face unnecessary barriers to care. According to Sarah Hoffman, director of the COPD Action Alliance, these gaps amount to a public health crisis.

While millions of U.S. adults have been diagnosed with COPD, countless others live with the disease unknowingly, missing out on early treatment that could help them live longer, healthier lives. Hoffman explains that lack of awareness and education are major barriers to diagnosis — many people don’t recognize early symptoms such as a persistent cough or shortness of breath, and stigma keeps others from speaking up. For decades, COPD has been unfairly labeled a “smoker’s disease,” which discourages people from seeking help and prevents open conversations among families and caregivers.

The report also highlights how systemic issues such as prior authorization and “step therapy” policies delay essential care. These insurance rules often force doctors to spend valuable time appealing denials or require patients to “fail first” on older, less effective medications before accessing the treatments their clinicians recommend. For patients in rural areas, these barriers can be even more severe due to long travel distances and limited access to specialists.

Hoffman emphasizes that COPD is not limited to smokers — veterans, firefighters and others exposed to occupational hazards face higher risks, and women are disproportionately affected. Genetic factors can also play a role.

Although a National COPD Action Plan was created in 2018 by the National Institutes of Health, it still hasn’t been implemented. Hoffman calls on policy makers to make COPD a national priority by funding education, supporting early detection and ensuring accountability in care standards.

Advocacy, she says, starts at the community level. During COPD Awareness Month, Hoffman encourages patients and caregivers to contact their legislators, share information and raise their voices to demand better access to care. As she puts it, awareness saves lives — and now is the time to act.