For Many, Weight Loss Surgery Won’t Be Covered
May 30, 2013When the Affordable Care Act became law in 2010, many bariatric experts were hopeful that there would be a uniform set of benefits for the whole country and that weight loss surgery would be covered as a treatment option for obesity. But mostly due to expense worries for some states, the U.S. Department of Health and Human Services changed course and decided to match the benefits to the most popular group plan sold state by state. This means that many uninsured Americans in over two dozen states won’t have coverage for bariatric surgery and other obesity-related treatments such as weight loss counseling and medications.
Ironically, some of America’s most obese states won’t have coverage. Mississippi, Texas, Alabama, Arkansas, and Louisiana just to name a few.
"If they don't have insurance, they're not going to get the therapy,” says Dr. John Morton, director of bariatric surgery for Stanford University. "We see cancer therapy covered routinely. We see heart disease covered routinely. Why is it that we don't see obesity coverage routinely?" Dr. Morton has led national lobbying efforts to get weight loss surgery covered by insurance.
Currently, approximately two-thirds of large employers and Medicare cover weight loss surgery in the United States. With the average cost of surgery being about $42,000-many smaller employers opt not to cover it.