Georgia to Take Away Weight Loss Surgery Coverage

As of January 1, 2012, state employees and others covered by Georgia’s state insurance, will no longer have insurance coverage for bariatric surgery. The government decided that it was too expensive to cover the weight loss surgery procedures, although research shows that in the longer-term, the cost of the surgery will likely be more than made up. Medical costs of treating obesity-related medical conditions (comorbidities) are reduced in patients who have bariatric surgery, as their medical conditions improve. The vast majority of states do cover bariatric surgery for their employees, with only 6 currently not covering it: Montana, Idaho, Pennsylvania, Louisiana, Kansas, and Oklahoma. According to CNN correspondant Elizabeth Cohen, Missouri stopped covering weight loss surgery for a period of time, but made the decision to begin coverage again when it saw the longer-term savings associated with the surgery.

CNN covered this issue today, and featured a potential bariatric surgery patient – Alice McCormick – who is currently undergoing the pre-surgery requirements for bariatric surgery. She is a retired teacher who is covered by Georgia’s state health insurance, and will now be unable to get this surgery because of the state’s decision. “As I get older, it becomes more and more imperative that I find an answer”, McCormick told CNN. She is suffering from high blood pressure, sleep apnea, arthritis, and acid reflex.

CNN legal contributor Holly Hughes was also interviewed for the story. Hughes had bariatric surgery as a county employee, and subsequently lost 145 pounds. About Georgia’s decision, Hughes said, “it’s frightening to me. You’ll stop all of these state employees from having access to the surgery. In the long-run it’s going to cost the state more because these are folks who are going to develop diabetes – if they don’t already have it – sleep apnea… things that can kill you.”

Hughes says that since the surgery, it’s not only her physical well-being that has drastically improved; it’s her mental well-being too. “What it does is it frees you up”, Hughes says. “You’ve accomplished that dream. It’s done. You check it off the list. And that – the benefits of the mental health – are amazing.”

Dr. Jaime Ponce, President-Elect of the American Society for Metabolic and Bariatric Surgery, and bariatric surgeon who treats patients from Georgia and Tennessee, spoke to us about this issue: “There is documented evidence that bariatric surgery is a cost effective treatment for morbid obesity and its associated comorbidities. An analysis of a private payer database showed that cost savings associated with bariatric surgery began accruing as early as 3 months after surgery although downstream savings were estimated to offset the initial costs in 2 to 4 years.” (1)

(1) Crimeaux PW, Buchwald H, Shikory SA, et al. Study on the Economic Impact of Bariatric Surgery. Am J Manag Care 2008;14:589.

Comments are closed.