TAMPA, FL (June 3, 2024) — The Obesity Action Coalition (OAC) and the STOP Obesity Alliance are proud to announce the release of the "Medicaid Obesity Treatment Coverage Study." This study is the first to analyze and investigate levels of state Medicaid coverage for obesity treatment options, beyond whether a benefit was covered or not.
Healthcare plans differ widely in how they cover treatments for the disease of obesity, making it difficult for people to know what is covered and how to get the treatments they need. To better understand Medicaid coverage, OAC and STOP analyzed data from state Medicaid programs for the year 2023, focusing on both Fee-for-Service and Managed Care plans. The study examined four main types of obesity care: nutrition counseling (NC), intensive behavioral therapy (IBT), obesity medications (OM) and metabolic and bariatric surgery (MBS). Each state was given a score based on how well they covered these treatments, noting any limitations at the patient level or restrictions that block access to treatment.
Medicaid Obesity Treatment Coverage at a Glance:
- No state fully provides access to comprehensive obesity care.
- Only fourteen states provide any kind of coverage for obesity medications.
- All states applied various levels of exclusions, limitations, or restrictions for the coverage of obesity treatments, which add complexity to accessing services and benefits.
- Although the majority of states cover metabolic and bariatric surgery, 28 states have so many limitations and restrictions that coverage is essentially not accessible.
- The majority of restrictions for all types of obesity treatments did not align with published clinical standards and guidelines.
The analysis highlights the urgent need to address the barriers to accessing obesity treatments within state Medicaid programs.
As a patient-focused obesity advocacy organization, OAC trains advocates to fight for expanded access to the comprehensive obesity care they need and deserve. Fortunately, many restrictions can be remedied without statutory changes. With these findings, advocates are better equipped to engage policymakers and administrations to expand access to obesity treatments.
The STOP Obesity Alliance, located within the George Washington’s University Milken Institute School of Public Health, consists of a diverse group of business, consumer, government, advocacy and health organizations dedicated to reversing the obesity epidemic in the United States. Drawing on the strengths of the collaborative, STOP conducts research, makes policy recommendations and develops hands-on tools for providers, advocacy groups, policymakers and consumers.
View the study and results at stop.publichealth.gwu.edu/coverage/medicaid-2024.
For more information about the study or to schedule an interview, please contact Kendall Griffey, OAC Communications Manager, at [email protected].
The Obesity Action Coalition (OAC), a more than 80,000-member-strong National nonprofit organization, is dedicated to improving the lives of individuals affected by the disease of obesity through education, advocacy and support.
-GW-