Persistent Pursuit of Access to Obesity Care

The Old Pine, Darien, ConnecticutIt can be tedious. But the truth is that persistent pursuit of access to obesity care does indeed bring incremental progress. The latest case study came this week in Connecticut, with Governor Ned Lamont signing a bill into law to provide better access to obesity care under the state’s Medicaid program.

Years of Effort

This victory came from years of effort. Here on ConscienHealth two years ago, Neil Floch described his own persistent pursuit of this goal for better obesity care access:

“Individually my patients plead for help. They feel a desperate need for coverage of medications or surgery. But speaking out publicly on this subject is extraordinarily difficult. The stigma of obesity is overwhelming. When people speak up, they open themselves up to humiliating criticism. They fear harsh judgment for their weight because so many people think of excess weight as a moral failing instead of what it really is – a biological problem that can destroy a person’s health.

“So we struggle to show the legislature how many people suffer daily from living with obesity. It is frustrating. We are grateful for the brave people who come forward to tell their stories. We hope for more.”

Yesterday, he got more for his patients when Lamont signed SB977 into law. This was the culmination of an effort in which the Obesity Action Coalition rallied patients and advocates to speak up for equitable access to care. As Floch noted in his 2021 commentary, it started a decade ago.

A Shift for Equity in Access to Care

Right now, access to real and effective obesity care is too often restricted to the few and the wealthy. This has got to change, as Hannah Stoops and Mohammad Dar explained yesterday in the New England Journal of Medicine:

“In medicine, the media, and the public sphere, the cause of obesity is often oversimplified as a basic caloric imbalance: too many calories in and not enough calories out. This platitude influences physician opinion and shapes insurance coverage, typically leading to a treatment approach focused solely on calorie-restricted dieting and increased physical activity.

“As understanding of obesity has evolved, we believe approaches to managing obesity as well as insurance coverage of these approaches must also shift, particularly in the Medicaid program.”

We are seeing this shift happen, though slowly. Pennsylvania this year opened up coverage for obesity medicines under the state’s Medicaid program. It took more than five years. We first testified for this in May of 2017.

The wheels grind slowly, but when we keep up our efforts to turn that crank, we see good things come from this process. Equitable access to care is a worthy goal that requires persistence.

Click here for more on the victory in Connecticut and here for the perspective in NEJM from Stoops and Dar.

The Old Pine, Darien, Connecticut; painting by John Frederick Kensett / WikiArt

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June 22, 2023

One Response to “Persistent Pursuit of Access to Obesity Care”

  1. July 01, 2023 at 10:27 pm, Eduardo Grunvald said:

    Recently in California, access to AOMs to our Medi-Cal (CA Medicaid programs) was extended for 3 more years.

    Eduardo Grunvald, MD