It’s Time for Congress to Address Medicare’s Discriminatory Prohibition on Anti-Obesity Medications

By Dr. Gerald Felando

In the battle against obesity, it’s crucial that our healthcare system evolves to address the needs of those affected by this chronic disease. Despite being a widespread and treatable condition, Medicare’s outdated policy prohibiting coverage for anti-obesity medications (AOMs) has hindered progress in combating this epidemic. It is imperative that Congress takes action this year to eliminate this discriminatory provision by introducing and passing the Treat and Reduce Obesity Act (TROA). By doing so, America will recognize obesity as a treatable chronic disease and achieve significant cost savings for the healthcare system.

Obesity is a pressing public health concern that affects millions of Americans, including those residing in California. According to recent data from the California Department of Public Health, the state’s obesity rates have been steadily rising over the years. In 2020, nearly 26% of California adults were classified as obese, and the prevalence among children and adolescents was approximately 14%. These statistics highlight the urgent need for comprehensive and accessible treatments to combat obesity.

One major barrier to effective treatment is Medicare’s outdated policy that excludes coverage for AOMs. While Medicare covers treatments for other chronic diseases, such as diabetes and hypertension, it fails to acknowledge the efficacy and importance of AOMs in addressing obesity. This discriminatory provision perpetuates the stigma surrounding obesity, treating it as a lifestyle choice rather than a medical condition.

The passage of the Treat and Reduce Obesity Act (TROA) would be a significant step towards rectifying this issue. TROA seeks to remove the prohibition on Medicare coverage for AOMs, allowing beneficiaries to access these vital medications. By doing so, Congress would send a powerful message that obesity is a treatable chronic disease deserving of proper medical attention and support.

Furthermore, the economic benefits of passing TROA cannot be ignored. Obesity-related healthcare costs in the United States exceed $147 billion annually, with Medicare bearing a substantial burden. By providing coverage for AOMs, we can significantly reduce healthcare expenditures in the long run. Numerous studies have shown that effective obesity treatment leads to improved health outcomes, reduced hospitalizations, and decreased overall healthcare costs.

Congress must take swift action to eliminate Medicare’s discriminatory prohibition on AOM coverage and pass TROA. By recognizing obesity as a treatable chronic disease and providing access to evidence-based medications, we can make significant progress in addressing this epidemic.

Not only will this benefit millions of Americans struggling with obesity, but it will also lead to substantial cost savings for our healthcare system. The time for action is now, let us ensure that no individual is denied the care they need to overcome obesity and lead healthier lives.

About the Author: Dr. Gerald Felando is a former California State Legislator and Member of the Assembly Health & Aging Committees (1978-1992). Retired from public office, Felando now spends time advocating for patient rights and access to affordable healthcare.