Provides for treatment of morbid obesity. (1/1/17) (RR NO IMPACT GF EX See Note)
The bill will formalize coverage standards for obesity treatment within group insurance policies, notably focusing on those with a BMI over 40 who also suffer from diabetes and hypertension. Among the notable aspects of this legislation, health insurance providers will only be mandated to cover a limited range of services for ages 17 to 65 and can impose specific guidelines for approval for surgical procedures. This is likely to standardize the treatment protocols and reduce disparities in services offered across different insurance plans.
Senate Bill 173, proposed in Louisiana, is aimed at providing health insurance coverage for the treatment of morbid obesity. It defines morbid obesity using a body mass index (BMI) threshold and requires group insurance plans issued or renewed after January 1, 2017, to cover medically necessary treatments such as bariatric surgery, outpatient visits, and nutritional education. However, this mandate does not apply to small group plans or those under the Office of Group Benefits, which raises concerns about equitable healthcare access for various groups within the state.
The sentiment surrounding SB 173 is mixed. Proponents argue that it is a necessary step to improve health outcomes for obese individuals and to recognize the serious health risks associated with morbid obesity. However, critics express concerns regarding the potential limitations on coverage and the age restrictions that may marginalize older patients. The controversy reflects wider debates on healthcare affordability and the responsibilities of insurers in managing chronic health conditions.
Key points of contention include the lifetime cap of $15,000 on surgical benefits and the limitation of coverage to a single surgery unless complications arise. Some stakeholders argue that these financial constraints could leave patients vulnerable if they require multiple procedures or post-operative care, thereby undermining the bill's intent to provide comprehensive care. Additionally, the exclusion of certain groups from coverage could pull back state-wide efforts to combat obesity and promote overall public health.