Majority of state exchanges exclude bariatric coverage

[southernlady]

http://www.diabeteshub.com/news/obe...overage/228818d49056aa991abdbfa2431e40f8.html

Majority of state exchanges exclude bariatric coverage


RICHARD FRANKI

01/28/16


The majority of state exchanges are not covering bariatric surgery for 2015-2016, but one state is set to make the switch to limited coverage in 2017, according to the American Society for Metabolic and Bariatric Surgery.

There are currently 28 states with benchmark plans on their insurance exchanges that exclude coverage of bariatric surgery, but Colorado will add coverage for bariatric surgery when it replaces the state’s current essential health benefits benchmark for 2017, the ASMBS reported.





Among the states not covering bariatric surgery are Texas, Florida, Ohio, and Pennsylvania. Those that do have coverage on their state exchanges include California, New York, and Illinois, the ASMBS noted. Four states – California, New Mexico, Massachusetts, and Michigan – and the District of Columbia have benchmark plans that cover weight-loss programs.

The ASMBS said that “state health exchange plans continue to utilize blanket exclusions for weight loss programs or any obesity management services [even though] such blanket exclusions for these services are contradictory to ACA-mandated coverage for [U.S. Preventive Services Task Force] recommended preventive services.”

Meanwhile, the society added, the U.S. Department of Health & Human Services “continues to sidestep its oversight authority in favor of letting states work out these issues – instructing advocates to contact state insurance commissioners for any kind of recourse.”

 

[SJB41976]

yep. thats why I'm self-pay. Tennessee excludes wls.

 

[Oneheadlight]

That is really interesting. If they continue to let the states work the issues out, this map will probably still look like this 5 years from now.

 

[DSRIGGS]

That is really interesting. If they continue to let the states work the issues out, this map will probably still look like this 5 years from now.

The ACA is a prime example how all the states rights bullshit doesn't work. Allowing states to pick and choose led to terrible results in many states (those where the dumbasses refused federal money). We need to get insurance out of the game and go to single payer with federally Universal guidelines, and the sleeve and DS absolutely need to be covered .

 

[Spiky Bugger]

When people keep voting against their own best interests, this is the inevitable outcome.

My SIL posts false story after false story...all she has to do is check at Snopes, but that's too much trouble. She hated Obamacare, but had to get it. It costs her nothing, but now she bitches that her office visit copay is $40 or $50. Her policy covers a lot of hospital-related costs. Prior to Obamacare, she would have paid closer to $100 for an office visit and had zero hopital insurance. But because she is an idiot and she hangs with idiots, she KNOWS Obamacare is a bad deal.

Her genius son, who posted an image of his $39k 2014 W-2, was "a Romney man." Didn't understand that he couldn't AFFORD to be a Romney man. (Maybe you can survive on that where HE lives, but here almost all of it would go to rent.) One day he posts that Hillary is not qualified to be president, but Trump is...the next day, he extols the virtue of the Danish tax system, because although you pay a lot, you get alot. Doesn't seem to get that he is promoting socialism. Moron.

Of course, twenty years ago, I had to explain to my MIL..the mother of the SIL, Grandmother of the Romney man...that she was NOT middle class. She was listening to her idiot friends, all complaining about how the gubmint was taxing the middle class to death. Her ANNUAL income, almost all from Social Security was under $4k. Finally, I said something like, "I'm not sure what you think 'middle class' IS, but your son makes more than your annual income every month...and we thnk we are middle class. You live in subsidized housing, you have Medicare, and the rent you do pay is from your SS check. Any taxes you pay, just multiply themselves and come back to you. Nobody is taking a damned thing from you."


ANYWAAAAY...the ridiculous argument that people should be allowed to purchase insurance across state lines... If that were allowed...all the people who don't want/need bariatric surgery would buy cheaper insurance in Mississippi or somewhere, lowering the number of people in "the group," causing the California insurance companies to close up shop, and then no one anywhere would have wls covered. Duh.

There is a book about ths kind of stupidity...What's the Matter with Kansas? Here is a part of a review:

A brilliant analysis-and funny to boot-What's the Matter with Kansas? is a vivid portrait of an upside-down world where blue-collar patriots recite the Pledge while they strangle their life chances; where small farmers cast their votes for a Wall Street order that will eventually push them off their land; and where a group of frat boys, lawyers, and CEOs has managed to convince the country that it speaks on behalf of the People.

 

[DianaCox]

OAC and ASMBS are trying to push something through to get bariatric surgery covered as a required/mandated treatment.
http://www.generalsurgerynews.com/I...iles-Bariatric-Surgery-Denial-Complaint/34815
https://asmbs.org/articles/american...f-obesity-treatment-under-affordable-care-act

 

[BebeZed]

The ACA is a prime example how all the states rights bullshit doesn't work. Allowing states to pick and choose led to terrible results in many states (those where the dumbasses refused federal money). We need to get insurance out of the game and go to single payer with federally Universal guidelines, and the sleeve and DS absolutely need to be covered .

I agree with you 100% but I believe the chances of this happening are slim and none. I hope I'm wrong!

 

[DSRIGGS]

It has to go to a universal, single payer system eventually. What pay for our health care isn't long run sustainable. The right wing of this country governs by fear and has convinced stupid people to be so afraid of the government that they believe having a 3rd party involved in health care and paying twice what any other modern country in the world pays for health care is better than single payer. We are a stupid country who deserves the shit sandwich we are served. Stupid people voting against their interests because they believe some uber wealthy old white guy who wants to live like it is 1950 and siphon off every penny from dumb people that he can.

We have a guy advocating the proper health care policy but Merrica is stupid they believe that Socialism (which we already have by the way ...we are a mix of socialism and capitalism) is Communism. The Right will sell it as that even if Sanders makes is through the primary (He won't).

A FB friend of mine posted this video of a canadian basically laughing at how stupid we are, and he is right. There are a few F bombs so please ignore that part and listen to his message.