Weight Loss Surgery Won’t Be Covered by Obamacare in Many States
Uninsured Americans who are hoping the new health insurance law will give them access to weight loss treatments are likely to be disappointed. That’s especially the case in the Deep South where obesity rates are some of the highest in the nation. Some states will not require health plans sold on the new online insurance marketplaces to cover medical weight loss treatments, whether prescription drugs or bariatric surgery.
That long-standing culture of large food intake in the Deep South has saddled Mississippi with the highest obesity rate in the nation. Doctors here are no longer surprised to see teenagers or young adults with diabetes, hypertension, and heart disease. The prevalence of severe obesity is growing rapidly. For those patients, bariatric surgery is considered one of the most effective treatments for weight loss.
The procedure is described as follows: The stomach size is restricted in which a patient isn’t going to eat as much. Then the intestines are re-routed a little bit and realigned to delay digestion and bypass it. Thus, everything a patient eats in a gastric bypass is not going to be absorbed. After surgery, many of the complications of obesity like high blood pressure are reversed.
Medicare and some two-thirds of large employers in the US cover bariatric surgery. However, the procedure is pricey. It is an average of $42,000. Many small employers, including those in Mississippi, won’t cover it. Amid worries that a uniform set of benefits would be too expensive in some states, the US Department of Health and Human Services changed course. It decided to have the benchmark plan to set the minimum level of benefits that must be covered.
That’s led to an odd twist. In more than two dozen states, obesity treatments, including intensive weight loss counseling, drugs and surgery, won’t have to be covered. Some of these states — Alabama, Louisiana, Arkansas, Texas and Mississippi — have the highest obesity rates in the nation. Still, some 15 million Americans who are severely obese still need medical treatment. If they don’t have insurance, they’re not going to get the therapy. It isn’t surprising that obesity treatments are excluded in plans sold for insurance. It all has to do with keeping costs down for many people who will be buying insurance for the first time.