Saud Anwar

Senator Anwar Joins Senate in Approving Medicaid Reimbursement for Surgical, Prescription Treatment of Severe Obesity

Today, State Senator Saud Anwar (D-South Windsor) joined the Senate in its approval of legislation allowing Medicaid and HUSKY-B reimbursement for medically necessary covered treatment of severe obesity, including surgery and outpatient drugs. Currently, Medicaid reimbursement of treatment for those conditions is only covered when obesity is caused by or exacerbates an illness. This bill effectively eliminates the requirement that a comorbidity exists in reimbursement of services and includes prescription drugs as a reimbursable treatment. Sen. Anwar helped introduce this legislation.

“Nearly 40 percent of American adults are obese, and this condition is linked to common chronic diseases including type 2 diabetes, high blood pressure and cardiovascular disease,” said Sen. Anwar. “Complicating matters is that many Americans who are obese lack nutritional education, reside in food deserts or otherwise experience societal conditions making obesity more likely. By allowing Medicaid coverage and CHIP coverage for obesity treatments such as prescription drugs and surgery, we can aid individuals in attaining the care they need and reduce the impacts of the obesity epidemic on our communities.”

“Obesity is treatable, it is associated with significant comorbidities and impacts the quality of life of a patient,” said Dr. Wajahat Mehal, a Professor of Medicine at Yale and the director of Yale’s Weight Loss Program. “Thankfully, science has reached a point where we have medicines which can address this. Not everyone needs a surgery; medical treatment can be very effective in a significant number of patients.”

Senate Bill 282, “An Act Concerning Medical Assistance For Surgical and Prescription Drug Treatment of Severe Obesity,” will beginning in April 2023 authorize the Social Services Commissioner to reimburse treatment for severe obesity including surgery and outpatient prescription drugs.

Under the legislation, “severe obesity” is defined as obesity with a body mass index of 40 or higher, or 35 or higher with comorbidities such as diabetes and hypertension. A BMI of 40+ would indicate a six-foot-tall man weighing more than 300 pounds or a woman standing 5′ 3″ weighing more than 225 pounds.

In public testimony, medical professionals approved of the legislation; Jonathan Aranow, MD, a former president of the Connecticut Chapters of the American Society for Metabolic and Bariatric Surgery, said the bill would generate more cost savings than expenditures within five years of passage, potentially saving the state $12 million annually. The legislation’s focus on individuals with increased risk of chronic diseases related to obesity will directly benefit state public health, medical professionals added. What’s more, obesity disproportionately affects minorities in Connecticut, 13.4% of children in the state are obese and more than half of COVID-19 patients hospitalized in the pandemic’s initial waves were obese, according to Pavlos Papasavas, MD, immediate past president of the CCASMBS.

Additionally, Papasavas said, Connecticut is the only state in New England where Affordable Care Act plans do not cover bariatric surgery; this legislation would benefit the state in cost savings while helping to improve public health and individual patients’ outcomes.