January – February 2023 OCC Advocacy Report

Prepared by Christopher Gallagher, OCC Washington Representative

118th Congress Convenes: Advocates Evaluating Changes for TROA

As the 118th Congress convened in January, obesity advocates began discussions with House and Senate champions for the Treat and Reduce Obesity Act (TROA). Given that it has now been more than 10 years since TROA was first introduced, supporters are evaluating possible changes to the legislation to address possible cost concerns that are rumored to be coming from the Congressional Budget Office (CBO).

While Senate Champions will remain the same this Congress, leadership of the House version of the bill will be taken over by Representatives Brad Wenstrup (R-OH) and Raul Ruiz (D-CA). It is also important to note that many key healthcare committees will now include leadership from past TROA supporters such as: Senator Cassidy as the new Ranking Member of the Senate HELP Committee; Representative Cathy McMorris Rodgers (R-WA) who is now chairing the House Energy & Commerce (E&C) Committee; and Representatives Brett Guthrie (R-KY) and Anna Eshoo (D-CA) who will serve as Chair and Ranking Member, respectively, of the House E&C Health Subcommittee.

OCAN Responds to CMS Request for Information on Essential Health Benefits

On January 31, 2023, the Obesity Care Advocacy Network (OCAN), and many OCAN member groups, sent individual comment letters to the Centers for Medicare & Medicaid Services (CMS) in response to the Agency’s Request for information (RFI) regarding issues related to the Essential Health Benefits (EHB) under the Patient Protection and Affordable Care Act (ACA). The purpose of the RFI is to seek public as part of a very broad examination of how our nation defines essential health care under the ACA and whether this care is being provided equally and equitably across the country.

In filing these extensive comments, OCAN touched on several areas of concern to the obesity community and urged CMS to:

  • recognize obesity as a complex and chronic disease and require EHB plans to cover all evidence-based treatment services under the appropriate EHB categories.
  • provide guidance to state EHB plans that mirrors the OPM language to Federal Employee Health Benefit (FEHB) which ensures coverage of FDA approved anti-obesity medications; and
  • address the discriminatory benefit design language surrounding obesity preventative care services, and to utilize the United States Pharmacopeia (USP) drug classification as the standard for determining drug classes within state EHB benchmark plans.

OCC Groups Testify before State Legislatures in Connecticut and Tennessee

During February, Obesity Care Continuum (OCC) groups presented testimony to key healthcare committees in the Connecticut and Tennessee state legislatures — urging state policymakers to support greater coverage of obesity care services such as IBT services, AOMs and bariatric surgery.

In Connecticut, OCC member groups were joined by the American Diabetes Association in supporting Senate Bills 976 and 977, which would require broader health insurance coverage for bariatric surgery and AOMs. In Tennessee, these groups came together again to speak in support of House Bill 1315/Senate Bill 674, which would allow for coverage of AOMs for TennCare beneficiaries — a major recommendation of the state’s Chronic Weight Management Task Force.