Almost a decade after obesity was formally classified a disease, coverage policies still disregard the impact of the complex chronic disease. But that could soon change.
Bipartisan federal legislation, the Treat and Reduce Obesity Act, would bring health care policy into alignment with health care reality.
Updating Outdated Policy
At issue is Medicare Part D’s outdated prohibition on covering obesity medication. Current regulations were developed before evidence-based obesity medications existed. That is why, even though more than 35% of seniors struggle with obesity and its comorbidities, potentially game-changing medications like semaglutide are not available to them.
While some argue the federal policy made sense given current research when it was passed, it’s time for a change. Obesity’s role in the nation’s public health crisis is undisputed. The chronic disease costs Americans more than $1.4 trillion per year. And it disproportionately afflicts patients in racial, ethnic and socioeconomic cohorts that have long found themselves on the wrong side of America’s health care inequities.
New Urgency Post-COVID
From diabetes to high blood pressure, cancer to COVID-19, obesity is a common denominator – arguably a root cause – of Americans’ poor health. In the last couple of years, it’s become apparent that even patients’ vulnerability to a once-in-a-lifetime viral pandemic is connected to obesity.
Medicare beneficiaries already have access to medications for health conditions caused by obesity. It’s just common sense for Congress to expand coverage to address the underlying problem too. The Treat and Reduce Obesity Act would do that by allowing Part D to cover obesity medications. Doing so would not only alleviate current suffering but also encourage research and investment by life science companies to continue developing new obesity medications.
The proposed legislation is not the last word, but it is an important first step.