Sending Office: Honorable Yvette D. Clarke
Sent By:

        Request for Cosponsor(s)


Ensuring Kids and Older Americans Have Access to Allergy Tests Help Reduce ER Visits, Hospitalization, and Missed School Days

CoSponsors: Rush, Raskin, Peters, Moulton, Pocan, Engel, Krishnamoorthi, Gonzalez, Bonamici,
Meadows, Johnson (Bill)


Endorsed by: National Medical Association


May 16, 2019

Dear Colleague:


According to the Centers for Disease Control and Prevention (CDC), allergies are the 6th leading cause of chronic illness in the United States with an annual cost in excess of $18 billion[i].
Over 50 million Americans suffer from allergies each year, and the symptoms range from mild to life- threatening. Without proper diagnosis, patients are likely to receive suboptimal care which can lead to serious asthma attacks or even anaphylactic shock.


Allergies are the result of the immune system mistaking an otherwise harmless substance as an invader, this substance is known as an allergen. This mistake leads to an overreaction and overproduction of antibodies which triggers
symptoms in the nose, lungs, throat, sinuses, ears, lining of the stomach or on the skin. Allergy testing is vital for children and adults and can reduce emergency room visits, hospitalizations, missed school days, and in serious cases save lives.


Allergy testing is usually performed using in vitro specific IgE tests (blood test) or percutaneous skin tests (skin prick test). According to peer-reviewed literature and guidelines from the National Institutes of Health, in vitro
specific IgE tests and percutaneous skin tests are considered equivalent as confirmatory tests in terms of their sensitivity and accuracy. In other words, blood-based allergy testing is as accurate as percutaneous skin testing. From a safety perspective, percutaneous
skin tests are generally safe tests for both adults and children with a low risk for systemic reactions or significant adverse events. Blood-based allergy tests have an even better safety profile with no risk for systemic reactions or significant adverse events.
However, despite the recommendation from peer-reviewed literature, the National Institutes of Health, and specialists from academic centers around the country some current Medicare local coverage determinations, and Medicaid coverage policies, deny equal coverage
and access to blood-based allergy tests.


Inequities in coverage and barriers to access to allergy tests which are safe and accurate lead to poor patient health outcomes and in extreme cases cause death. There is also an unnecessary financial burden associated with healthcare
disparities resultant from a lack of equal access to allergy testing coverage. For these reasons, we reintroduced H.R. 2009,
Removing Barriers to Allergy Diagnostic Testing Act of 2019. This legislation will remove barriers which inhibit patient coverage and access to safe and accurate allergy tests, thereby empowering patients with the personal healthcare information which
can help them live healthy productive lives.


Startling statistics of the impact allergies have on missed school and work days include:

•         The CDC reports in 2013 that 49% of children with asthma reported missed school days associated with asthma[ii].

•         African Americans are three times more likely to be hospitalized from asthma and three times more likely to die from asthma[iii]

•         Asthma is the leading cause of school absences from a chronic illness for children ages 5 to 17, with students missing an average of 8 days of school per year. It also results in more hospitalizations than any other childhood

•         Almost half (44%) of all asthma hospitalizations are for children[v]

•         The CDC also reports that 33.8% of adults with asthma reported missed work days in 2014[vi].



We invite you to cosponsor H.R. 2009, to remove barriers to allergy tests and improve health care outcomes for children and adults living with allergies. If you have any questions, please feel free to contact (Clarke, 5-6231) or (Upton, 5-3761).





Yvette D. Clarke                                                                                              Fred Upton

Member of Congress                                                                                        Member of Congress


[i] Centers for Disease Control and Prevention (2017). Gateway to health communication and social marketing practice. Retrieved April 8, 2019 from

[ii] Centers for Disease Control and Prevention (2015). Asthma-related Missed School Days among Children aged 5–17 Years. Retrieved May 2, 2019 from

[iii] National Heart, Lung, and Blood Institute (2012). Reducing Asthma Disparities. Retrieved May 3, 2019 from

[iv] Hatice S. Zahran, H.S; Bailey, C.M.; Damon, S.A.; Garbe, P.L.; & Breysse, P. N. (2018).  Vital Signs: Asthma in Children – United States, 2001 – 2016. Centers for Disease Control and Prevention. Retrieved
May 3, 2019 from

[v] AsthmaMD (2018). Asthma statistics. Retrieved May 3, 2019 from

[vi] Centers for Disease Control and Prevention (2018). Adult missed days and activity limitation: Percentage of adults with current asthma who reported missed days of work in the past 12 months by state/territory.
Retrieved May 3, 2019 from

Related Legislative Issues

Selected legislative information: HealthCare, Science

Related Bill Information

Bill Type: H.R.
Bill Type: 2009
Special Note:

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