Obama Administration Hosts Public Forums on Essential Health Benefits

by Chris Gallagher, OAC Policy Consultant

Winter 2012

During November, the U.S. Department of Health and Human Services (HHS) held a number of regional listening sessions across the country to hear from local stakeholders about which services should be included in the essential health benefits (EHB) package for the new state-based health exchange plans being developed under the health care reform law.

OAC advocates and other representatives from the obesity community spoke at each of these sessions about the “essential” nature of obesity treatment and why it is critical that HHS include these services in the EHB package.

OAC Advocates in Action

One such advocate is Tammy Beaumont, RN, from Texas. Throughout the last year, Tammy has become a passionate advocate for the OAC and all Americans affected by obesity by volunteering her time to visit legislators in Congress as part of OAC Capitol Hill Advocacy Days. Most recently, Tammy stood up at one of these HHS regional listening sessions held in November in Dallas.

As someone who described herself as “fairly apathetic as far as politics go” prior to her visit to Capitol Hill this summer, Tammy has now become a true advocacy force for the OAC. In describing this evolution, Tammy shared with us that her experience at the HHS listening session “was just another ‘wow moment’ for me as I saw how being an advocate for a cause can be so rewarding.”

Tammy continued…

“This is the first time I’ve ever been so passionate about an issue to be willing to step out of my comfort zone and speak up. I’ve found that because I’m so comfortable with the subject matter, speaking up has been far easier than I would have expected. Words just seem to flow and sound genuine and unrehearsed. I may not always use enough of the correct buzz words, but I think I get the point across with both a personal and professional perspective.”

Issues for HHS Listening Sessions

In offering these public forum events across the country, HHS hoped to learn more about the following specific issues:

1. In keeping with the title of the Institute of Medicine report “Essential Health Benefits – Balancing Coverage and Cost,” how can the department best meet the dual goals of balancing the comprehensiveness of coverage included in EHB and affordability?
2. How might the department ensure that EHB reflect an appropriate balance among the categories so that they are not unduly weighted toward any category?
3. What policy principles and criteria should be taken into account to prevent discrimination against individuals because of their age, disability status or expected length of life as the Affordable Care Act requires?
4. What models should HHS consider in developing the EHB package?
5. What criteria should be used to update EHB throughout time and what should the process be for their modification?

In addition to Dallas, HHS Regional Listening Sessions were held in Boston, New York City, Philadelphia, Kansas City, Atlanta, Denver, Seattle and San Francisco. OAC Board of Director Chairman Pam Davis, RN, CBN, made the trek from Nashville, Tenn., to speak at the Atlanta listening session – ironically the only public forum held in the southeast region of the country where obesity rates are among the highest in the country.

In addressing the Atlanta Forum, Ms. Davis reiterated the message that OAC continues to hammer home at federal and state policymakers regarding: the complexities of the disease; the critical need to both prevent and treat obesity; and how the societal hurdles of bias and stigma continue to hinder comprehensive efforts to help those affected. In closing, Ms. Davis reminded HHS officials that:

“100 million Americans are currently affected by obesity. For the first time in history, America’s children are being diagnosed with type 2 diabetes, hypertension and are said to have a shorter life-expectancy than that of their parents. Thankfully, with the advancements in modern medicine, and an open mind by policymakers, we can reverse this trend. I urge HHS to use its wide discretionary powers in defining the benefit package and stand up for those who struggle with obesity.”

OAC Advisory Board member Walter Medlin, MD, made the pilgrimage across Washington state from his home in Spokane, Wash., to address the Seattle event. Dr. Medlin, both a bariatric surgeon and patient, spoke candidly about some of the “bottom line” issues surrounding obesity treatment – both economic and spiritual. In his remarks, referring to himself as “the face of metabolic surgery,” Dr. Medlin highlighted how he has:

“…greatly benefited from the taxpayers of the state of Washington and the United States who paid tens of thousands of dollars to subsidize my medical education and surgical residency training. After less than 10 years in practice, that could have all been lost to a fatal or permanently disabling event related to my severe obesity. I would have been unable to deliver the services that our community invested in, and would have ceased being a ‘productive’ member of society – THINK taxpayer versus tax burden! Luckily, I had the resources and the access to pay out of pocket for bariatric surgery – an intervention that has given millions of people worldwide a second chance – what I refer to as my bonus life!”

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