Arkansas is Overweight & Affordable Care Act Doesn’t Care

3/25/2016 (PRESS RELEASE JET) -- Despite the growing rates of obesity in America, approximately half of the country’s states do not provide for coverage of bariatric surgery under the Affordable Care Act. Currently, only 22 states have a specific requirement for the coverage of gastric bypass or bariatric surgery.

These 2 surgeries, bariatric and gastric bypass, have been proven time and again as an effective measure against obesity by reducing the physical size of the stomach and the overall urge to eat. However, according to a report in 2011 on National Healthcare Disparities, the Agency for Healthcare Research and Quality determined that despite the growing increase in obesity rates, fewer healthcare professionals are informing their patients when they are obese or overweight, and the potential consequences of comorbid conditions. Many believe that this could be one of the contributing factors behind US adults using preventative care services at a fraction of the recommended rate.

No Coverage in Arkansas for Bariatric Surgery or Gastric Bypass

In a brief provided by the Robert Wood Johnson foundation, it is determined that under the Affordable Care Act, Washington DC and 36 states will provide some form of weight-loss treatment as an EHB (Essential Health Benefit), and will therefore have it included in their health insurance plans.

According to this brief:

• 25 states have coverage for nutrition counselling
• 23 states have coverage for bariatric surgery
• 5 states have coverage for other weight loss programs

Currently, the only weight loss program covered by standard Arkansas health care plans is nutrition counseling. While some private insurance plans do provide for bariatric surgery and gastric bypass for patients in Arkansas, they typically have strict standards that decide who is eligible for coverage. However, due to Arkansas’ Act 855, public school teachers and state employers would have access to state insurance coverage for weight loss surgeries, including gastric banding and gastric bypass surgeries for morbidly obese people.

In addition, the Centers for Medicare & Medicaid Services (CMS) has established a national coverage policy that covers bariatric surgery for those who are obese in order to reduce the health risks associated with obesity. However, there are strict requirements that must be met in order for individuals to be eligible for treatment.

While 15 million adults in the United States have morbid obesity, as indicated by BMI, approximately 1% of those who are clinically eligible ever receive treatment through bariatric surgery. Yet, statistics have shown that overweight and obese individuals spend approximately 77% more on medication and 42% more on medical expenses per year.

When you consider the fact that insurers typically recover the costs of bariatric surgery within 2 to 4 years, depending on the weight loss surgery performed, it would seem that weight loss surgery would be considered as an essential health benefit (EHB).

For more information on the Leave No State Behind campaign, you can visit the American Society for Metabolic and Bariatric Surgery. In addition, you can also find state specific information for key policymakers in Arkansas. By joining the campaign, you can lobby for improved bariatric coverage by health insurance companies, and ensure that Arkansans have access and coverage for the weight loss programs they need.

National Bariatric Link
https://www.NationalBariatricLink.org

https://www.youtube.com/watch?v=UEhq-DS6Ejs