In red states, Obamacare plans don't cover bariatric surgery. (Bariatric surgery society map; click the image to enlarge it.) |
In red states, state-employee plans don't cover the surgery. (Bariatric surgery society map; click the image to enlarge it.) |
Jon Gould, a surgeon at the Medical College of Wisconsin, notes that insurance companies could save money in the long term by covering bariatric surgery, since it often fixes expensive chronic health conditions like diabetes. "But state budgets, which help fund Medicaid, are often pinched and need immediate returns on investment, not savings on insulin and doctors’ visits that may not add up until five or 10 years later," Khazan reports.
Plans that do cover bariatric surgery often impose high barriers to qualify for it, such as requiring patients to quit smoking, not gain any weight for three months before the surgery, or fail at following a structured diet program for six months.
Outdated ideas about obesity as a personal failure may also be a factor. In Mississippi, where more than 37 percent of adults are obese, a bill to help bariatric patients pay for surgery in Mississippi stalled out in 2015 after it became known locally as the "belly-band bill."
"Adding a bariatric benefit in a conservative state where there is a prejudice or bias against morbidly obese people . . . so many people think you're enabling them," said David Dzielak, Mississippi's former Medicaid director.
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