ASMBS Reports Insurance Coverage Still Lacking for Bariatric Surgery and Obesity Drugs
The American Society for Metabolic and Bariatric Surgery (ASMBS) believes passage of the "Patient Access to Evidence-Based Obesity Services" resolution by the American Medical Association (AMA), the nation’s largest physician group, will help in the fight to improve patient access to evidence-based obesity treatments including intensive behavioral counseling, FDA-approved obesity drugs and bariatric and metabolic surgery.
Currently, only 22 of 50 states have bariatric surgery listed as a covered benefit within the Affordable Care Act (ACA) and only five states provide coverage for weight loss programs. According to the ASMBS, the specific exclusion of obesity treatment in the ACA state health exchanges is unusual and in conflict with the ACA’s own stated statute that state health exchanges may not exclude treatment on the basis of a health condition. In addition, many private health insurers, employers and state health plans maintain exclusions on obesity treatment.
"Obesity is perhaps the most undertreated disease in America despite the availability of safe and effective treatments," said Ninh T. Nguyen, MD, President of the ASMBS, the nation’s largest organization of bariatric and metabolic surgeons and integrated health professionals. "This is largely because insurance coverage is so limited. With this latest resolution, the drum beat for greater access and coverage is growing louder and we are hopeful that public and private insurers and policy makers are listening and will take quick action."
The new resolution, which was passed this week without opposition, comes nearly a year after the AMA officially designated obesity a disease. The resolution states, "Resolved that our AMA, consistent with H-440.842 Recognition of Obesity as a Disease, work in concert with national specialty and state medical societies to advocate for patient access to the full continuum of care of evidence-based obesity treatment modalities (such as behavioral, pharmaceutical, psychosocial, nutritional, and surgical interventions)."
The ASMBS, American College of Surgeons (ACS), The Obesity Society (TOS), Obesity Action Coalition (OAC), American Association of Clinical Endocrinologists (AACE), American Society of Bariatric Physicians (ASBP), Society of American Gastrointestinal and Endoscopic Surgeons, Society for Vascular Surgery, American Society of Plastic Surgeons, and American Urological Association all helped support the passage of the AMA resolution. The resolution was passed on Wednesday, the same day the ASMBS was afforded a seat in the AMA House of Delegates (HOD). HOD, which includes more than 500 voting delegates, is the principal policy-making body of the AMA.
"The AMA’s support of treatment for individuals with obesity underscores the national imperative to treat our leading public health problem. The time has come for equitable treatment for the millions of patients affected by obesity. There needs to be one America where treatment for obesity is available to all," said John Morton, MD, MPH, ASMBS President-Elect.
Obesity is one of the country’s greatest public health and economic threats. The Centers for Disease Control and Prevention (CDC) reports more than 72 million Americans have obesity and, according to the ASMBS, about 24 million have morbid obesity. Individuals with a body mass index (BMI) greater than 30 have a 50 to 100 percent increased risk of premature death compared to healthy weight individuals, as well as an increased risk of developing more than 30 obesity-related diseases and conditions including Type 2 diabetes, heart disease and certain cancers.
About the ASMBS
The ASMBS is the largest organization for bariatric surgeons in the nation. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for morbidly obese patients.