Opening

Three Openings for Obesity in the Affordable Care Act

The Obesity Society’s advocacy advisor, Ted Kyle, recently talked with the Cronkite News Service about openings for better coverage of obesity in the Affordable Care Act (embedded video below). The ACA is a bit of a mixed bag for people concerned about obesity, but it provides some good openings for progress.

The three most important openings for obesity in the Affordable Care Act are:

  1. Improved Access to Health Insurance. According to an analysis by Morgan Downey and Christopher Still, the importance of eliminating pre-existing conditions to determine rates and access to insurance “cannot be overstated.” Prior to the ACA, 35 states allowed insurers to charge people with obesity more for insurance. Two states explicitly allowed insurers to deny coverage to people with obesity. Nine percent of cancellations of health insurance were based on weight. All of these discriminatory practices are now illegal.
  2. Access to Intensive Behavioral Treatment. The ACA mandates free access to intensive behavioral therapy for obesity because it is recommended as an evidence-based intervention by the U.S. Preventative Services Task Force.
  3. Nondiscriminatory Benefit Design. Under the ACA, an insurer is not meeting standards for essential health services if “its benefit design, or the implementation of its benefit design, discriminates based on an individual’s age, expected length of life, or present or predicted disability, degree of medical dependency, quality of life or other health conditions.” This language, say Downey and Still, provides a opening for challenging plans that deny coverage for medically necessary obesity treatment. Make no mistake, there’s lots of ambiguity here, but an opportunity nonetheless.

 
Without a doubt, much remains up in the air about how well these and other provisions relevant to obesity in the Affordable Care Act will work. Plenty of bad news can be found for obesity in the ACA, too. It will do nothing to quickly improve coverage of obesity drugs. Systematic solutions for delivering medical obesity care are far from being fully developed. We could go on, but it would be depressing.

Click here to read the detailed analysis of openings for obesity in the Affordable Care Act from Downey and Still.

Opening, photograph © Víctor Nuño / flickr

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