Extra Harshness of Health Insurance on Obesity?

For most Americans today, the reality of health insurance is harsh. More than half of us have enrolled in high-deductible health plans that can bankrupt us if we get sick. Insurers play games to deny people coverage for expensive drugs they can’t possibly afford out of pocket. So is the harshness of health insurance toward people with obesity even greater than average?

A Case Study in Abusive Practices

In excruciating detail, ProPublica documents the hellish experience of Christopher McNaughton with UnitedHealthcare, his health insurance provider. Back in 2014, he was a healthy athlete studying psychology until his junior year at Bard College when he developed severe ulcerative colitis. For years after that, the disease dominated his life, keeping him from returning to school or a normal life because of his debilitating symptoms.

After four years of this suffering, he found a treatment that worked, but it was expensive. He returned to normal life for a few years and his health insurance covered the extraordinary costs of the expensive biologics that controlled his disease. He returned to school at Penn State (in his hometown) and enrolled in the student health plan provided by UnitedHealthcare with the assurance that it would cover his medical expenses.

But it didn’t work out that way. After a time, UnitedHealthcare flagged his case as a “high dollar account” and tried to deny coverage for his treatment. A nurse for United discussed his case with another employee, who laughed when she told him McNaughton’s treatment would be labeled medically unnecessary. “I knew that was coming,” he said. They agreed that the family would be wasting their time with any appeals. “We’re still gonna say no.”

Only after a lawsuit and endless wrangling did United relent and pay the bills. Yet United still keeps threatening to cut McNaughton off.

It’s All About the Money

The harshness of these games instigated by health insurance tie back to one simple factor – money. Expensive diseases, expensive medicines, and a drive to cut costs no matter what.

McNaughton’s medical bills – more than a million dollars a year – make even the most expensive drugs for obesity look downright cheap. But harassing people with obesity is much easier. Weight stigma and misconceptions about obesity make them good targets.

In the end, for health insurers, it’s all about the money. Avoiding bills for obesity care means more profits for the company. No matter that leaving obesity untreated leads to many other expensive chronic diseases.

As McNaughton’s case illustrates in vivid detail, those expenses down the road are not such a big worry for health insurers because they have many tools for dodging responsibility.

Click here to read the full details of McNaughton’s experience, here and here for more on the intersection of high drug prices and health insurance.

Currency, the Common Measure of Trade; 15th century illustration by unknown artist / Wikimedia Commons

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February 7, 2023