Momentum Growing for Action on Obesity Care!
by Christopher Gallagher
Mr. Gallagher is a Washington Policy Consultant for the Obesity Action Coalition (OAC), The Obesity Society (TOS), American Society for Metabolic and Bariatric Surgery (ASMBS), and Obesity Medicine Association (OMA) in Washington, DC.
Funding: No funding was provided for this article.
Disclosures: Christopher Gallagher works with the Obesity Action Coalition, Obesity Society,
American Society for Metabolic and Bariatric Surgery, and Obesity Medicine Association.
Bariatric Times. 2022;19(3):12.
Abstract
This article addresses the significant progress made toward improving patient access to comprehensive obesity treatment services through grassroots advocacy efforts. The article also highlights state and federal activities to improve obesity care coverage, such as the Treat and Reduce Obesity Act (TROA).
Keywords: Obesity, TROA, access, coverage, Medicare, Medicaid
Twenty-seven years ago, I met my first bariatric surgeon. Back then, in 1995, I was working for the American College of Surgeons (ACS), and I had been tasked with taking around Capitol Hill the leadership of a fairly new society, which was then called the American Society of Bariatric Surgeons. The majority of our time on the Hill was spent explaining what “bariatric” meant and often educating skeptical congressional staff that obesity is, in fact, a complex and chronic disease.
A lot has changed since then—mostly for the positive! A growing majority of federal and state policymakers now accept that obesity is a disease and that patients should have access to science-based treatments. Much of this momentum has resulted from the American Medical Association’s (AMA’s) House of Delegates 2013 decision to recognize obesity as a complex disease and support patient access to the full continuum of care of evidence-based obesity treatment modalities.
AMA support for access to obesity care and grassroots efforts from the obesity community have resulted in the following strong statements supporting coverage of obesity treatment.
In 2014, the Office of Personnel Management put health plans that serve federal employees on notice that the agency will no longer tolerate plans excluding obesity treatment coverage on the basis that obesity is a lifestyle condition or that treatment is cosmetic. Not a mandate, but a strong message to health plans that they must provide a clinical rationale for excluding these services.
In 2015, the National Council of Insurance Legislators, the organization that represents legislators who chair insurance committees in state legislatures across the country, adopted its first ever disease-specific policy statement, urging Medicaid, state employee, and state health exchange plans to update their benefit structures “to improve access to and coverage of treatments for obesity such as pharmacotherapy and bariatric surgery.”1
In 2018, the National Lieutenant Governors Association went on record supporting efforts to reduce obesity stigma and support access to obesity treatment options for state employees and other publicly funded healthcare programs.
In 2020, the National Hispanic Caucus of State Legislators and National Black Caucus of State Legislators adopted a formal policy recognizing that health inequities in communities of color have led to a disproportionate impact of COVID-19 and that states must address the high rates of obesity to improve the health of racial minorities, prepare for the next public health epidemic, and ensure that their constituents, including those using Medicaid, have access to the full continuum of treatment options for obesity.
States across the country are listening to these calls for action! For example, state employee health plans have expanded coverage for bariatric surgery in Pennsylvania, Wisconsin, Georgia, and Louisiana. Coverage for anti-obesity medications (AOMs) is also growing in state plans, such as the recent adoption of AOM coverage in Minnesota’s Medicaid program. Finally, there are many states that are close to expanding obesity care coverage, such as Pennsylvania, Connecticut, and Massachusetts.
While state level efforts remain promising, obesity advocates continue to struggle with gridlock in Congress, where we are now approaching the 10-year anniversary of the introduction of the Treat and Reduce Obesity Act (TROA), legislation that will expand Medicare coverage so seniors can access both United States (US) Food and Drug Administration (FDA)-approved medications for chronic weight management, as well as intensive behavioral counseling services from a more diverse range of healthcare providers. Despite the strong support of more than 150 Republican and Democratic members of Congress for TROA, the bill has yet to come up for a committee or floor vote since it was first introduced in 2012.
Following passage of the Affordable Care Act, the Obesity Action Coalition (OAC), The Obesity Society (TOS), American Society for Metabolic and Bariatric Surgery (ASMBS), Obesity Medicine Association (OMA), and the Academy of Nutrition and Dietetics (AND) founded the Obesity Care Continuum (OCC). With a combined membership of more than 150,000 healthcare professionals, researchers, educators, and patient advocates, the OCC is dedicated to promoting access to and coverage of the continuum of care surrounding the treatment of overweight and obesity.
Developing the legislative language for TROA was one of the first major projects undertaken by the OCC. The coalition’s success at identifying congressional champions for TROA and the formal introduction of TROA in 2012 encouraged OCC members to grow their numbers by creating the Obesity Care Advocacy Network (OCAN), which now has more than 35 national organizations from both inside and outside of the obesity community. OCAN’s mission is to change how the nation perceives and approaches obesity in the US. OCAN seeks to elevate obesity on the national agenda by uniting and aligning obesity stakeholders and the community around key obesity-related efforts.
Since OCAN joined the fray in supporting TROA, we have seen bipartisan support for the legislation grow to nearly 200 House of Representatives and Senate members in each of the previous two Congresses. Entering the second session of the 117th Congress, our support now stands at 150 House and Senate supporters. OCAN’s leadership was also the major catalyst behind more than 100 health and obesity care advocacy organizations, including the National Urban League, National Black Nurses Association, League of Latin American Citizens, Black Women’s Health Imperative, National Hispanic Medical Association, and WW International Inc., signing on coalition letters urging leaders on Capitol Hill and in the administration to follow the science and provide treatment options for the growing number of Americans living with obesity who lack access to comprehensive care.
Finally, as you read this article, OCAN member groups will have just met with roughly 100 congressional offices during Obesity Care Week (February 27–March 5) to support the passage of TROA. Please help us let Congress know that it’s time for action on TROA by sending a letter to your members of Congress via OCAN’s Action Center. You can do so at https://www.obesityaction.org/troa/?utm_source=spotlight-action. Working together, we can get TROA across the finish line!
Reference
- National Conference of Insurance Legislators. (NCOIL). Resolution in support of efforts to reduce the incidence of obesity and chronic disease. 19 Jul 2015. https://ncoil.org/wp-content/uploads/2016/04/07232015ObesityResolution.pdf. Accessed 25 Feb 2022.
Category: Commentary, Past Articles
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