Keith Siegel of Union has been a respiratory therapist for over 40 years, managing multiple clinical hospital departments, and is currently an active member of the American Association for Respiratory Care. 

For over four decades, I’ve helped people breathe easier as a respiratory therapist. I evaluate medical oxygen equipment, flow levels and symptoms to understand patients’ needs. Helping patients manage their clinical needs is incredibly rewarding.

My work is also deeply personal. Living along Maine’s coastline and managing my own lifelong pulmonary condition, I understand the stakes of accessing oxygen therapy in ways that few policymakers ever will. 

I’ve also seen this in my own family, with both my father and father-in-law living with chronic obstructive pulmonary disease (COPD), confined to their homes because they could not access portable oxygen. I’ve seen it in my work in acute and home care settings across rural Maine, where the nearest hospital can be miles away, and resources are limited. And I’ve seen it most clearly when patients are sent home from the hospital or their doctor’s office without the tools, guidance and support they need to properly manage their respiratory illness. 

All too often, respiratory patients have little understanding of their oxygen equipment, how to use it or troubleshoot problems. Without support from a trained respiratory therapist, there is no one to adjust or monitor their oxygen care or recognize signs of exacerbation, which can lead to worsening symptoms and hospital readmissions. 

Respiratory therapists are uniquely trained to assess oxygen levels and needs in real time and intervene when patients show early warning signs of decline. Without proper evaluation and adjustment, patients may be undertreated or misinformed about their oxygen therapy.

But the care we provide at a loved one’s home is critically undervalued — and not even directly reimbursed through the Medicare program. For those who need to use supplemental oxygen at home, even for a limited time, like my wife, who had a heart condition and needed oxygen for a month, access limitations hurt patients, caregivers and families.

These access limitations result from payment policies that don’t adequately reflect the true costs for providing high-quality supplemental oxygen care in the home setting.

One of the most striking examples of this I’ve seen is the limited availability of liquid oxygen due to Medicare’s competitive bidding program, which reduced reimbursement for liquid oxygen so low that suppliers can no longer offer it to patients. Liquid oxygen has become essentially unavailable across Maine, despite its importance for those who require higher-flow oxygen or greater mobility. Losing access to this care isn’t just inconvenient; it’s a life-changing barrier to remaining active and independent. 

That’s why I urge Maine’s lawmakers to pass legislation that would improve patient access to liquid oxygen and offer reimbursement for respiratory therapist services to ensure patients receive the critical clinical oversight they currently lack. Without reform, barriers to care will continue to grow. The Supplemental Oxygen Access Reform Act (H.R. 1406/H.R. 2902) would advance several reforms to ensure more patients can get safe, quality respiratory care at home.

For those with lung diseases or other complex health conditions, access to oxygen — and a respiratory therapist to ensure it’s used safely and effectively — is what transforms clinical stability into freedom and well-being for patients. The SOAR Act would stabilize reimbursement rates while enacting patient-centered policies to ensure patients receive reliable, high-quality care and supplemental oxygen that best fit their medical needs. 

Turning clinical stability into real independence requires more than equipment: it requires expert support from a respiratory therapist. Better support for oxygen services and better access to RTs would mean better health outcomes for our patients. 

I encourage Maine’s lawmakers to swiftly support the SOAR Act.