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Obesity? Come Back and See Us When You Have Diabetes

We have a long climb ahead of us. A new study published in the International Journal of Obesity this week makes it clear. Health plans still are not taking obesity care seriously. A careful analysis of coverage for obesity drugs documents what we’ve known for some time. Coverage is spotty at best. Health plans seem to be saying, “come back for care when you have a bigger health problem.”

Rarely Covered in the ACA Marketplance

Gricelda Gomez and Fatima Cody Stanford focused on 34 states with federally-facilitated marketplaces. Among those states, only seven Medicaid programs covered obesity drugs. That’s 20%.

But worse, only 11% of the ACA marketplace plans had any coverage for obesity drugs in those states. Stanford, an obesity medicine physician at Harvard, is clearly frustrated. She tells us:

This study shows that coverage for obesity medications is poor under the current ACA. In order to improve the health of patients with obesity, we must ensure adequate coverage to evidence-based treatments, such as medications, to ensure the best health outcomes.

Resistance from Many Directions

Resistance to covering obesity drugs comes from many sources. Perhaps the biggest is inertia. Plans have never covered them before. They’ve never needed to. That’s because effective options were scarce. For a health plan it’s simple dollars and cents. One more benefit means more expenses. That means either higher premiums or lower profits.

But here’s the thing. These patients will be back. Untreated obesity progresses. It progresses to diabetes and a host of other chronic diseases. The first line of treatment for those diseases is weight management.

Unfortunately, because of poor coverage for weight management, providers quickly move on to merely treating obesity’s complications. So the bills pile up for diabetes and all those other complication.

Pay now or pay later. But make no mistake, health plans are paying for obesity. They’re simply choosing to pay later, at a much higher cost.

Click here for the study in IJO. Click here for more on the costs of untreated obesity.

Closed, photograph © Masaaki Komori / flickr

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November 22, 2017

4 Responses to “Obesity? Come Back and See Us When You Have Diabetes”

  1. November 22, 2017 at 8:16 am, Allen Browne said:

    Your headline made me laugh! A sick, cynical, sardonic, sad laugh.

  2. November 22, 2017 at 9:34 am, Ted said:

    Anything to make you smile, Allen. Thanks!

  3. November 23, 2017 at 11:34 am, Susan Burke March said:

    I didn’t say it, but I’ll repeat it. How the U.S. deals with healthcare. Wait. It’s not “healthcare”, it’s “sickcare.”

  4. November 23, 2017 at 11:57 am, Ted said:

    Sadly true, Susan.