Obesity Community Comments on State Exchange Benchmark Plan Selection for Determining Essential Health Benefits Package
by Chris Gallagher, OAC Policy Consultant

To view a PDF of this article, click here.

In August, the OAC joined with other leading groups from the obesity community (American Society for Metabolic and Bariatric Surgery [ASMBS], The Obesity Society [TOS], The American Society of Bariatric Physicians [ASBP] and Academy of Nutrition and Dietetics [A.N.D.]) in submitting joint comments to a number of states, which are in the process of choosing a benchmark health plan to determine the scope of their essential health benefits (EHB) package.

In the wake of this summer’s Supreme Court ruling on the Affordable Care Act, many states have jump started this process which entails the state choosing one plan for its benchmark from either the:

  • Three largest small group plans
  • Three largest state employee plans
  • Largest commercial HMO plan
  • Three Federal Employees Health Benefits plans

Therefore, many states are soliciting public comment from stakeholder groups (such as the OAC) regarding which health plan would be the best choice for the state to select – based on balancing coverage and cost. Throughout the last month, the obesity community delivered comments on this critical issue to state policymakers in Arizona, Colorado, Kentucky, Maryland, Nebraska, New Mexico, Nevada, New York, Rhode Island, Tennessee and Utah.

Each of these state-specific comment letters were based on significant research by the leadership of OAC, TOS, ASBP, ASMBS and A.N.D. to determine which health plan provides the best coverage of obesity treatment services.

In the comments, the obesity community urges policymakers to recognize that:

“Similar to many other medical conditions, obesity is a complex, multifactorial chronic disease, which requires a multidisciplinary treatment approach. This approach must encompass the best standards of care, both in terms of the treatments chosen, and the care coordination and clinical environment in which they are delivered…and just as those affected by heart disease receive their care through a coordinated multidisciplinary treatment team, those affected by obesity should also follow a similar continuum of coordinated care. Because of the complex nature of obesity and its variety of impacts on both physical and mental health, effective treatment requires the coordinated services of providers from several disciplines and professions (both physician and non-physician) within both of these treatment areas.”

As you can see, the obesity community feels it is very important that the disease of obesity be treated just like any other disease state.

For more information about open public comment periods in your state, please contact OAC Policy Consultant Chris Gallagher at chris@potomaccurrents.com. To view the comments submitted to date, click here.



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