One in three American seniors lives with chronic pain, and Medicare, the program built to cover their care, still treats chiropractic like it is 1972. That year, chiropractors were added to Medicare, but coverage was limited to exactly one service: manual manipulation of the spine, commonly known as an adjustment. More than fifty years later, that is still the only chiropractic service Medicare pays for. Not the exam. Not the evaluation. Not the things a chiropractor’s licensing board requires before care ever begins. Seniors deserve the ability to choose their healthcare provider and to receive the services each state’s scope of practice authorizes.
The Chiropractic Medicare Coverage Modernization Act, H.R. 539 / S. 106, finally fixes that. When it passes, Medicare’s chiropractic coverage will reflect what doctors of chiropractic are already licensed by their states to do, similar to the broader recognition already seen in the VA, Department of Defense, federal employee health plans, and private insurance. Nothing in the bill changes any state’s scope of practice. Medicare is a payer, not a scope authority; it simply brings chiropractors into parity with other physician-level Medicare providers. The support is already there: 166 House cosponsors, nearly evenly split between the parties, and 15 in the Senate (verified against congress.gov, July 16, 2026). What the bill needs now is a committee vote. That is exactly what constituent pressure produces.
The profession is united behind passage and is advocating three strengthening amendments through the formal amendment process. The message: pass the bill and make a good bill better.
1. Define covered services by state-authorized scope of practice. Cover chiropractic care within each state’s authorized scope of practice, including but not limited to conservative, non-drug, non-surgical neuromusculoskeletal care, including the adjustment to correct subluxations. This sets a clear boundary: Medicare coverage would not extend to drugs, surgery, or obstetrics. These are not routine parts of chiropractic practice, and the profession is not seeking Medicare coverage of them.
2. Add Medicare opt-out / private contracting rights for Doctors of Chiropractic, modeled on the existing physician opt-out framework under Social Security Act §1802.
3. Enactment and implementation timeline. Include an implementation timeline to ensure regulations are promulgated within a reasonable period following enactment.