By Jen Haberkorn
THE WASHINGTON TIMES
Many insurers have been covering obesity treatments for the past several years, so yesterday's federal announcement that obesity will be considered an illness under Medicare will not lead to a change in their policies, they said yesterday.
Nearly half of all large employers already cover bariatric surgery, in which the stomach is stapled so that patients eat less food and absorb fewer calories, according to a 2003 William Mercer National Survey of Employer-Sponsored Health Plans. One-third of the plans covered only those who also participated in behavior-modification programs.
Virginia's and Maryland's insurance codes require that all insurance plans in the states cover surgeries that treat obesity, such as gastric bypass and bariatric operations.
People who are morbidly obese, defined as 100 pounds overweight for that person's age, height and sex, are covered for surgical treatment under the Virginia code, according to Bureau of Insurance spokesman Andy Farmer. Any alterations to the code would come from the General Assembly.
Democratic Virginia Gov. Mark Warner's office said it will observe the policy change's impact in Virginia.
"The governor has a great deal of interest in trying to encourage healthier lifestyles especially among our Medicare and Medicaid populations," said Warner spokeswoman Ellen Qualls. "It could end up that there could be legislative efforts brought to the 2005 Virginia General Assembly along those lines."
Since October 2001, Maryland requires coverage of the surgical treatment of obesity. A small portion of Maryland employers � those with two to 50 employees � is not subject to the mandate, said Brenda Wilson, chief of health insurance and managed care at the Maryland Insurance Administration.
However, one human resources group says the new federal policy eventually could drive up the price of coverage.
The policy change probably will increase health care costs for employees and employers, said a national panel member of the Society for Human Resource Management who did not want to use his name. Eventually the costs will trickle down to employers, and employees will see a decrease in coverage.
"It's definitely going to impact costs," the panel member said. "It's going to put more pressure on the system. There's going to be less coverage, higher deductibles and more co-pays."
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nsurance companies that sell supplemental Medicare coverage probably will have to offer additional services, but other insurance companies are not likely to be affected by yesterday's announcement, Ms. Wilson said.
The Blue Cross Blue Shield Association and most private-sector insurance companies already cover obesity-related surgeries, said Alan Korn, senior vice president of the Blue Cross Blue Shield Association.
Some cover other treatments, such as therapies and visiting diet specialists. The private health care industry figured out about five years ago how to treat obesity claims, Mr. Korn said.
Blue Cross offers surgical treatment of obesity as a coverage option, Mr. Korn said.
The nationwide association of health plans covers some anti-depressants known to help obesity patients, counseling and certain surgical procedures.
Mr. Korn said Blue Cross Blue Shield has seen a significant increase in the number of obesity-related surgeries performed across the country, although he did not have any statistics.
The number of short-term and long-term disability claims directly linked to obesity more than doubled from 2001 to 2003 at New York-based Metropolitan Life Insurance Co., also known as MetLife, according to a January statement.