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NCOIL pushes for expanding obesity treatment benefits

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State lawmakers who have an interest in insurance say consumers should have more access to weight-control benefits.

Members of the National Conference of Insurance Legislators (NCOIL), a voluntary professional group for state lawmakers, voted recently, at their summer meeting in Indianapolis, to approve a resolution backing efforts to expand health plan weight-control benefits.

Rep. Marcus Hunter, La., sponsored the resolution.

“The passage of this resolution demonstrates the legislative awareness that obesity is a disease having the latent effect of reducing worker productivity and increasing medical costs,” Hunter said in a statement about passage of the resolution.

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The Patient Protection and Affordable Care Act (PPACA) calls for each state to shape individual and small-group benefits by choosing a typical plan to serve as a “benchmark” plan, or model for the PPACA exchange major medical plans sold in the state. Even many states that have turned their exchange programs over to the U.S. Department of Health and Human Services (HHS) HealthCare.gov system pick benchmark plans.

In the NCOIL obesity resolution, NCOIL members call for any state that picks a benchmark plan to consider choosing a plan that offers coverage for ordinary weight-control programs, anti-obesity drugs and bariatric surgery.

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A state should offer the insurers that sell qualified health plans (QHPs) through its exchange incentives to cover weight-loss drugs and bariatric surgery, NCOIL members say.

Some researchers have argued that bariatric surgery clearly improves the health of the people who get the surgery and will eventually reduce the cost of obesity-related health care services. Other researchers have argued that claims that bariatric surgery will reduce overall health care costs may be incorrect, and that the early results suggest that, even after insurers pay for the bariatric surgery itself, post-surgery claims are about the same for the patients who get the surgery and comparable obese patients who do not get bariatric surgery.

Hunter and other NCOIL members come down on the side of the researchers who say paying for aggressive weight-control efforts should save money. They argue in the resolution that they believe effective measures to reduce the body mass index of obese Americans by 5 percent could save the country about $30 billion over five years and about $158 billion over 10 years.

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