Letter Writing Week: An Open Letter to the Louisiana Health Plans Association
Two-thirds, or 68 percent of Americans are affected by excess weight, and more than one-third (35 percent) are affected by obesity. This number is only continuing to rise. As many as 65 percent of American adults are recommended for bariatric treatment, but often times these treatments aren’t being covered by health insurance plans.
Insurance coverage of medical weight management is currently inadequate, and because of this, many individuals affected by excess weight and obesity can’t get the specialized care that they need to get their health on track. What’s the result of not receiving this care? An economic burden that’s placed on the healthcare system, because these individuals will require medical treatment for the conditions and diseases often associated with obesity, such as type 2 diabetes, high blood pressure (hypertension) and heart disease.
According to “The State of Obesity: Better Policies for a Healthier America,” the state of Louisiana currently has the fourth highest obesity rate in the Nation, and that number has increased from 22.6 percent in 2000, and 12.3 percent in 1990. In today’s letter, OAC member Ava Zebrick writes the Louisiana Health Plans Association about denial of coverage for weight management treatments under current policies of employer-based healthcare plans, and why it’s important that individuals have access to this important treatment.
An Open Letter to the Louisiana Health Plans Association
Thirty-five percent of adults in Louisiana are affected by obesity, and another 30 percent are considered to be overweight according to the body mass index (BMI). This epidemic is connected to severe comorbidities, such as diabetes, heart disease and cancers that reduce not only life expectancy but also the quality of life of many individuals. Obesity can have a devastating impact on one’s life, and it financially burdens patients and our healthcare system. The Louisiana Association of Health Plans can help reverse the epidemic in our state by improving access to obesity care.
My own metabolic issues presented themselves when I was just 5 years old, and they worsened over the next two decades. At 25 years old, my BMI exceeded 45, and I had hypertension, took multiple diabetes medications, and was facing imminent knee surgery. My employer based health plan co-insured the medical costs of complications due to severe obesity, and yet I was denied treatment for this underlying disease. Of course, knee surgery would be covered, but the policy excluded weight management treatments, “regardless of medical necessity.” By its own admission, obesity treatment was medically necessary.
Individuals affected by obesity and excess weight deserve access to evidence-based care. Is it acceptable for insurers to exclude procedures for heart disease? To deny patients with diabetes access to insulin? To exclude medical care for arthritis? Most employer health plans do not cover access to registered dietitians, weight management programs supervised by medical professionals, anti-obesity drugs, or metabolic surgery. It is my opinion that effective obesity care should be included in health plans as an essential benefit, and that employers should not have the option to exclude its coverage.
We need members of the Louisiana Association of Health Plans (LAHP) and insurance administrators across the state to help secure access to effective and cost-effective obesity care. In order to bring about change, we need partnerships with the LAHP, patient advocacy groups such as the Obesity Action Coalition, community organizations, health system leaders, medical professionals, researchers, and public agencies.
About the Author:
Ava Zebrick is an OAC member whose life was changed at the OAC’s 3rd Annual Your Weight Matters National Convention in 2014. She heard from leading obesity experts and advocates, connected with other OAC members affected by obesity and left with a purpose – to help advance access to obesity care. To make the greatest impact possible, Ava returned to the University of New Orleans, where she is currently working on a Masters degree in Healthcare Management and getting involved in obesity care efforts across the state of Louisiana.