HHS feels the heat from medical groups over 27 states denying bariatric surgery
- Five medical groups have filed a complaint with the Department of Health and Human Services (HHS) stating the 27 states that deny bariatric surgery coverage are in non-compliance with the ACA and violate the ban against denying coverage for a pre-existing condition or based on health status. The groups also claim the action is discriminatory against women and people with disabilities.
- The groups also state in their complaint there is significant disparity among the states’ ACA plans that deny or exclude bariatric surgery coverage and those private and government plans that do provide such coverage.
- Bariatric surgery is the most effective and long-lasting treatment for morbid obesity with a very low likelihood of major complications (4%) and results in significant weight loss, according to the American Society for Metabolic and Bariatric Surgery (ASMBS).
The groups that filed the complaint include the ASMBS, the Obesity Society, the Academy for Nutrition and Dietetics, the Obesity Medicine Association and the Obesity Action Coalition.
The American Medical Association (AMA) classified obesity as a disease in 2013. Medicare, 49 state Medicaid plans, the majority of state health plans, and employer health plans with 500 or more employees cover bariatric surgery.
Dr. John M. Morton, president of the ASMBS, and chief of bariatric and minimally invasive surgery at Stanford University School of Medicine, said, “Qualified health plans should not be able to discriminate against people with the disease of obesity and unfortunately, this is happening in most states.” He added, “Most insurers are covering the treatments for the complications and consequences of obesity, but are not covering the treatment of obesity itself.”
There were more than 78 million obese Americans in 2011 to 2012, according to the Centers for Disease Control and Prevention (CDC), and the ASMBS estimates 24 million people have severe or morbid obesity. A new report by Grand View Research Inc. estimates the global bariatric surgery devices market will hit $2.8 billion by 2022.