Inside Health Policy: Obesity Care Advocates Want Medicare Coverage Of Treatment Added To Reconciliation

Original Post: Inside Health Policy

Obesity care advocates are optimistic the Senate will include a measure in its upcoming reconciliation package to cover FDA-approved anti-obesity drugs under Medicare Part D and expand beneficiary access to intensive behavioral therapy, although the measure hasn’t been touted as a priority by leadership, which faces pressure to ratchet back its current health care plans in order to shrink the size of the reconciliation package.

The Treat and Reduce Obesity Act (TROA), a bipartisan bill introduced in both chambers of Congress this year, would allow Medicare to cover intensive behavioral therapy for obesity provided by practitioners beyond the standard primary care providers. The bill also seeks to cover obesity treatment and weight loss management drugs under Medicare Part D.

Part D hasn’t covered weight-loss drugs since coming onto the scene in 2006, but there’s been innovation in obesity treatment medications since then. Medicare needs to be expanded to reflect this new reality, the Obesity Care Advocacy Network wrote in letters sent earlier this month to congressional leadership.

“Our health care and payment systems should give those living with obesity access to safe and effective treatments for obesity,” Joe Nadglowski, co-chair of the Obesity Care Advocacy Network and president and CEO of the Obesity Action Coalition, said during a press call last Friday (Sept. 17).

Congress tends to make major changes to Medicare through the reconciliation process, which is why the Obesity Care Advocacy Network is pushing for this policy now, Nadglowski said.

Congressional leaders and White House officials have not publicly mentioned including the TROA provisions in the reconciliation package. They’ve already pledged to include a slew of health care priorities -- including additional Medicare benefits, a fix to the Medicaid coverage gap, extended enhanced Affordable Care Act tax credits and an infusion of funding into home- and community-based services.

The House Energy & Commerce and Ways & Means committees have already passed their contributions to the House reconciliation package, and neither committee moved to expand Medicare to cover obesity treatments.

However, the Senate version of the bill, which the House would likely then pass, has yet to be released. Negotiations around what will be included and at what level are ongoing. After meetings with President Joe Biden on the reconciliation package on Wednesday (Sept. 22), Sen. Bernie Sanders (I-VT) reportedly said there would be a lot of give and take, given Democrats’ slim majorities in both chambers.

Nadglowski said the group has discussed including the TROA provisions in reconciliation with the bill’s Senate sponsors.

“I think there continues to be positive response. Of course you know everything around reconciliation is still a challenge, right, and we know not everyone will get everything they want, but we are optimistic that this legislation will be included,” Nadglowski said.

Sen. Tom Carper (D-DE), a cosponsor of the bipartisan bill in the Senate, did not directly answer questions from Inside Health Policy about whether he’s pushing to include the policy in reconciliation. A spokesperson for the senator said he continues to discuss a path forward for TROA with other senators.

The Senate Finance Committee also did not respond to questions about negotiations to add TROA to their contribution to the package.

If the Senate doesn’t stick TROA into its reconciliation package, Nadglowski hopes to see the policy passed through future legislation, perhaps in another Medicare-related bill, he said.

-- Maya Goldman (mgoldman@iwpnews.com)