As Council on Black Health Releases New White Paper Indicating Insurance Programs Must Provide Access to Obesity Treatments to Address Systemic Racism In Healthcare, Health Equity Coalition for Chronic Disease Reissues Calls for Urgent Action from Biden Administration & Congress to Advance Health Equity

WASHINGTON, D.C. — Today, following the release of a new white paper from the Council on Black Health — indicating that improving access to anti-obesity medication through insurance coverage is necessary for reducing bias and racism in healthcare — the Health Equity Coalition for Chronic Disease reissued its urgent calls on the Biden administration and Congress to remove barriers to obesity care for communities of color. The new white paper from the Council on Black Health is the latest in a rapidly growing body of studies and public comments from the nation’s leading health advocates, racial equity leaders, and medical experts calling on the administration and congressional leaders to take immediate action to expand access to comprehensive obesity care for communities of color being disproportionately impacted by the obesity epidemic. 

Dr. Elena Rios — President and CEO of the National Hispanic Medical Association and Co-Chair of the Health Equity Coalition for Chronic Disease — released the following statement:

“The obesity epidemic is growing with alarming speed, rippling consequences across Black and Brown communities who are disproportionately impacted. These communities deserve access to the full continuum of care — including medication treatments — but Medicare’s discriminatory policies still deny access to FDA-approved obesity medications that could help turn the tide in communities of color. This outdated policy has spurred countless leaders this year to stand up and urge the Biden administration and Congress to finally update and modernize obesity policy. We are proud to be among those pushing for action, standing alongside our coalition members as well as health advocates, medical experts, and a range of diverse voices from across the political spectrum. It’s time that our elected leaders prioritize the health of communities of color who deserve the care and treatment needed to effectively combat obesity and turn the tide on this epidemic.”  

Momentum Growing Across the Country for Updating Obesity Policy

The obesity epidemic is one of the worst public health crises in the U.S. It has surged to unprecedented levels — with 60% of Black women and nearly half of all Black and Hispanic Americans now living with obesity. The American Medical Association designated obesity a chronic disease in 2013, and the number of states with high rates of adult obesity more than doubled since 2018. Despite this dangerous surge, Medicare continues to exclude FDA-approved anti-obesity medications from Medicare Part D coverage — prompting national leaders this year to speak out and press for immediate action. 

Among the national health advocates, racial equity leaders, and medical experts calling for action this year include:

The Health Equity Coalition for Chronic Disease issued a white paper in June laying out what’s at stake for communities of color — making the case that the “clock is ticking” and “now is the time to change policies” to provide comprehensive care and treatments for individuals suffering from the disease of obesity — and joining with 30 national health equity leaders and obesity advocates to urge CMS to expand access to obesity care for communities of color. 

The American College of Physicians (ACP) announced in April a new initiative aimed at advancing equitable access to obesity care. ACP plans to utilize physician education, advocacy, and partnerships to advance a stigma-free culture in which patients and clinicians collaborate to prevent and manage this increasingly common chronic condition, to ensure equitable access to care for patients and to help counter public misinformation about the causes of obesity, the stigma around it and the equity issues around how it’s treated. 

The American Medical Association sent a letter to CMS in January, urging coverage for anti-obesity medications in Medicare Part D coverage: “These treatment services and programs should be considered “essential” under the ACA’s mandated 10 EHB categories. For example, self-measured blood pressure devices and lifestyle change programs should fall under the broad “preventive and wellness services and chronic disease management” category and fixed-dose combination hypertension drugs and anti-obesity medications should be covered under the “prescription drug” category.” This followed the release of AMA’s comprehensive strategy to address obesity and reduce barriers to care. 

The American Medical Women’s Association released a white paper and call for action on obesity in December 2022, asserting: “Strategies for treating and addressing obesity are not one-size-fits-all. There is a need for a multi-pronged clinical approach to obesity … One big challenge is coverage … Anti-obesity medications are not covered by Medicare Part D, the insurance plan for most older Americans. Medicare policy currently omits therapies labeled as “weight loss” or “weight gain” agents. This can pose a significant challenge for patients covered through commercial plans who lose that coverage when they switch to Medicare. Lack of coverage also conveys the unspoken message that obesity treatment is not essential, even though studies have shown otherwise. … The lack of insurance coverage makes treatment out of reach for many patients, particularly those of lower socioeconomic status and who live in historically under-resourced areas.”

The American Diabetes Association kicked off their obesity treatment access initiative, including a series of new resources on their website. The ADA’s Chief Medical Officer highlighted ADA’s position in an op-ed in STAT News: “Medicare specifically prohibits covering reimbursement of obesity medications. As a result, health care professionals are left to treat patients without access to clinically proven and effective tools to promote weight loss, including FDA-approved pharmaceutical therapies to treat obesity.

The health care system and insurers need to take obesity seriously. To do so, they must start by ensuring patients and health care professionals have access to the full array of evidence-based, safe, and effective treatment protocols through comprehensive insurance coverage.”

Dr. Angela Fitch, the Associate Director of the Massachusetts General Hospital Weight Center and faculty at the Harvard Medical School, said during an event in June: “The biggest barrier to care today is actually access to care in two ways: One is the insurance coverage of care. And the second thing is the sheer volume of patients that are seeking care today. And so I think it’s complicated by both of those things. You know, it’s not just a one and done issue … We need to do something urgently to try to provide better access to effective treatment, because it really should not be allowed for people not to have access to them … We understand that there are cost implications to treating obesity, but there are also dramatic cost savings.”

Debra Fraser Howze, Founder of ChooseHealthyLife, made the case at an event in June that while 40% of Americans over 60 live with obesity, CMS doesn’t cover the full continuum of obesity care which is creating a healthcare disaster especially for aging Americans of color: “With tens of thousands of people aging into Medicare every day in America… all of us are coming onto the system, and the scary thing about this is, that we’re coming onto the system obese and ill. And the question is: If CMS does not address this, because it’s a Medicare issue, and all of these other health programs have access, what do we do?”

Daniel E. Dawes, the Executive Director of the Satcher Health Leadership Institute, in June made the case at the CMS Health Equity Conference how the obesity epidemic is rooted in systemic failures that continued to deny treatments to those who need it: “Obesity is a disease that contributes to many co-morbidities, is exacerbated by many of the social determinants of health that we think of, and disproportionately impacts individuals of color … In 2001, Dr. David Satcher’s Surgeon General report called attention to it and here we find ourselves in 2023, still discussing whether or not to classify obesity as a chronic disease and what levels of access to obesity fighting treatments are available … Those limiting decisions—how to classify the disease and who gets access to the treatments that will fight it—are the very political determinants of health that have the capacity to effectuate significant and lasting change.”

Dr. Fatima Cody Stanford, Associate Professor of Medicine at Harvard and one of the nation’s top obesity experts, made the case at the National Action Network’s convention in April that lack of access to obesity treatment is killing communities of color: “Obesity is the number one chronic disease in human history … But let’s talk about what’s really killing us every single day. Only 1% of us receive treatment with medications to treat our obesity.” 

Dr. Garfield Clunie, the President of the National Medical Association, argued in April that lack of access to obesity medications is creating a pandemic level crisis within communities of color: “The full range of treatment is met with significant barriers from health care providers, policymakers, insurers, and public opinion because people simply don’t believe obesity is a chronic disease. Many don’t recognize that lifestyle choices are not always effective, and they don’t realize the inequities in access to treatment. Medicare — which serves millions of Black and Hispanic Americans — denies coverage of anti-obesity medications.”

The National Council on Aging in February made the case that addressing obesity among older adults will require Medicare to cover the full continuum of treatments: “Obesity care also remains out of reach for tens of millions of older Americans because Medicare fails to recognize obesity as a serious disease—creating a gap in the full continuum of care for all older adults living with obesity. It’s time to recognize obesity as a serious, chronic disease so we can build a holistic and equitable approach to obesity prevention and management.”

Six U.S. organizations including The Obesity Society, the Academy of Nutrition and Dietetics (the Academy), American Society of Metabolic and Bariatric Surgery (ASMBS), Obesity Action Coalition (OAC), Obesity Medicine Association (OMA), and the Strategies to Overcome and Prevent (STOP) Obesity Alliancecollaborated to develop a consensus statement on obesity, aiming to address the various roadblocks that the organizations face when addressing efforts to improve access to obesity treatment and reduce weight stigma and bias surrounding the disease. The statement makes clear: “Every person with obesity should have access to evidence-based treatment.”

Learn more about the Health Equity Coalition for Chronic Disease at www.HealthEquityAction.org. 
For media requests, please contact Shafeeqa Kolia at Shafeeqa@precisionstrategies.com.