EXPANDING MEDICAID COVERAGE OF ANTI-OBESITY MEDICATIONS WILL SAVE LIVES AND MONEY
By Karla Thomas
Earlier this year, Governor Kathy Hochul used her State of the State Address to call attention to longstanding health inequities in the state. Most notably, she highlighted the fact that existing regulations make it difficult to deliver anti-obesity medications (AOMs) to New York’s Medicaid enrollees.
For Medicaid enrollees, the speech and subsequent policy proposal around expanding Medicaid coverage of AOMs was a welcome sign. Unfortunately, despite all the promise of the proposal, it still falls short of what is needed to address the obesity epidemic plaguing our state and the vulnerable communities that make up the Medicaid rolls.
As opposed to broadly expanding Medicaid coverage of AOMs for all enrollees that need them, the proposal calls for expanding coverage only for those at high risk of cardiovascular events.
This limited approach leaves far too many Medicaid enrollees without access to proven treatments, perpetuating the very health inequities that must be addressed. Beyond that, it will not make a meaningful dent in tackling obesity, and in the long run will cost our state lives and increase healthcare costs.
Statewide, just under 30 percent of New Yorkers are affected by obesity. In my home county of Erie, the number jumps to nearly 34 percent, and in the neighboring counties of Cattaraugus and Genesee, it is even higher at close to or above 40 percent. The fact of the matter is that more rural and lower income communities, alongside minority and disabled communities—the ones that rely on Medicaid—all have higher rates of obesity.
But this isn't just a matter of statistics – it's a matter of life, death, and treating this disease more effectively.
Our state loses nearly 27,000 lives prematurely each year due to obesity. The reason is its link to a myriad of other serious chronic diseases. Things like diabetes, hypertension, kidney disease, some cancers, and more are all directly connected to excess weight.
Beyond that, due to hospitalizations, doctors’ visits, and treatment for the various comorbidities, obesity is an extremely costly disease. State Medicaid costs alone approach $900 million annually, and the state shoulders an additional $30 billion each year related to lower economic activity, disability costs, and higher costs for employers.
More effectively treating this disease with AOMs and broad expansion of coverage under Medicaid for them can change this. We can improve the health of our Medicaid enrollees, reduce the prevalence of deadly comorbidities, and save money at the same time.
AOMs can reduce the risk of hospitalizations from cardiovascular disease—our nation’s number one killer—by more than 40 percent after just two years of treatment. At the same time, a 5 to 25 percent weight loss among New York adults under age 65 could potentially save the state $22 billion to $53 billion in medical costs over the first 10 years alone.
We are falling behind other states in addressing this crisis. More than a dozen states, including neighboring Pennsylvania, Massachusetts, and Connecticut, have already expanded their Medicaid programs to include coverage for AOMs.
It is time for New York to join them.
Comprehensive Medicaid coverage of AOMs without limitations is an essential step forward. More than just treating a disease, expanding coverage can ensure that health disparities can begin to disappear. I t can guarantee that zip code, income level, race, or disability status don't determine who gets to live a healthy life.
New Yorkers affected by obesity deserve full access to proven treatments. The time for bold action is now.
Karla Thomas is a longtime community leader, member of Bflo-Niagara National Action Network & the former Director of Community Outreach & Marketing for the Community Health Center.