ICYMI: Bipartisan Policy Center Highlights TROA and the Need for Obesity Care Coverage

As the treatment landscape for obesity continues to evolve, people living with obesity face significant insurance coverage obstacles to accessing the full range of care options. One of the key opportunities for addressing this coverage gap is the Treat and Reduce Obesity Act (TROA), a piece of bipartisan legislation that would provide Medicare beneficiaries with access to intensive behavioral therapy (IBT) and FDA-approved anti-obesity medications (AOMs).  

At a recent event hosted by the Bipartisan Policy Center (BPC), experts shared their perspectives on obesity as a disease and the current state of obesity care coverage. The panelists, including legislative staff, medical experts, and leaders from professional organizations, emphasized the importance of expanding Medicare coverage for AOMs and IBT through TROA, and the role that providing obesity care can play in reducing health disparities.  

Here are some key highlights from the discussion:  

Obesity is a disease that requires coverage for care to improve health outcomes. 

• Caroline Frauman, Legislative Assistant, Representative Gwen Moore (WI-04), pointed out that since Medicare was initially prevented from covering AOMs, our understanding of obesity has shifted. It is not a cosmetic issue; it is a disease that needs to be treated.  
• Dr. Michael Knight, Clinical Assistant Professor of Medicine, The George Washington University, explained that managing obesity by “eating less and moving more” is a decades-old mindset that does not work. Obesity is caused by a complex biological process that tries to keep the body at a set weight. Treating obesity requires a comprehensive approach.
  

Insurance coverage remains an issue for those living with obesity and TROA is an important mechanism for ensuring coverage.  

• The Medicare program currently does not cover AOMs. Frauman said that there is broad, bipartisan recognition of the need to address obesity holistically through TROA. TROA is an important step to correct this issue.  
• Dr. Michael Knight said that as a physician, it is frustrating to see that all obesity care options are not available to patients on Medicare. These barriers to access are not equitable. He said he looks forward to no longer having to stop discussing obesity treatment options just because someone is on Medicare.   
• Kate McEvoy, Executive Director, National Association of Medicaid Directors (NAMD), made the point that Medicare coverage is a bellwether for state Medicaid programs. Although Medicare does not cover AOMs, Medicaid programs have the opportunity to treat coverage as an investment in greater health and prevention, particularly as more evidence for their efficacy emerges. 
  

Providing obesity care coverage is worth the cost.  

• Dr. Christa-Marie Singleton, Chief Medical Officer, U.S. Office of Personnel Management (OPM), explained that the greatest share of our medical spend for federal employees and retirees comes from cardiovascular diseases and cancer. Obesity is a significant risk factor for both of these conditions. Obesity care has demonstrated the ability to help manage blood pressure among federal employees. AOMs may increase costs in the short-term, but these costs will be offset over time.  
• G. William Hoagland, Senior Vice President, Bipartisan Policy Center, discussed the trade-offs associated with covering the latest generation of AOMs, saying that increasing coverage for GLP-1s could result in a short-term increase in healthcare costs but could also result in an increase in economic growth due to greater worker productivity. He noted that the Preventive Health Savings Act would allow the Congressional Budget Office to account for cost-offsets like these when evaluating legislation like TROA. 
  

For all the reasons panelists at BPC’s recent event noted, we must work together to advance policies like TROA to improve access to obesity care and treatment. Check out the EveryBODY Covered Activation Hub for ways you can get involved in this work.