OCAN Statement on December 2023 Senate HELP Committee on Diabetes

December 19, 2023

WASHINGTON, DC – The Obesity Care Advocacy Network (OCAN) appreciates the U.S. Senate HELP Committee’s understanding during the hearing “What is fueling the Diabetes Epidemic?” on December 14th that we must address the disease of obesity to improve outcomes and reduce the incidence of diabetes.

The purpose of the hearing was to examine the various ways that Americans are impacted by both Type 1 and Type 2 Diabetes. In his prepared remarks, Chairman Senator Bernie Sanders highlighted the need for better access to medications to treat diabetes and obesity. Ranking Member, Senator Bill Cassidy, M.D., stated in his prepared remarks that there needs to be solutions to addressing the high rates of obesity and its association with diabetes. One way to do that, he argued, is to focus more attention on the need for research on obesity by the National Institutes of Health (NIH).

The Obesity Care Advocacy Network (OCAN) supports both the need for and access to comprehensive obesity care by all Americans, as well as an increased focus on obesity research by the NIH. Unfortunately, barriers to access to all components of evidence-based obesity treatment and care is limited for Medicare and Medicaid beneficiaries as well as those with private insurance. The passage and enactment of the Treat and Reduce Obesity Act (TROA), introduced in the U.S. Senate by Senator Tom Carper and Senator Cassidy, represents an important step toward comprehensive obesity care in the Medicare program, setting a standard for Medicaid and private insurance.

While we understand that TROA is not under the jurisdiction of the HELP committee, the legislation in consideration would provide solutions to the obesity epidemic discussed at the hearing. TROA is designed to effectively treat and reduce obesity in older Americans by enhancing Medicare beneficiaries’ access to the providers best suited to deliver intensive behavioral therapy (IBT) and by allowing Medicare Part D to cover Food and Drug Administration (FDA)-approved anti-obesity medications (AOMs).

The obesity epidemic has damaged our nation’s health. Among older adults (aged 60+), the prevalence of obesity is 42.8%, similar to the level among younger and middle-aged adults. The prevalence of severe obesity among those aged 60+ is 5.8%. More than 20% of the population will be 65 years of age or older by 2030, up from 15% today, highlighting the importance of addressing obesity among older Americans.

Currently, intensive behavioral therapy is restricted in Medicare (and by many private payers) by the types of healthcare providers who can deliver services (only primary care physicians, nurse practitioners, and physician assistants) and it also limits the settings of care to primary care clinics. These restrictions leave many qualified providers, like registered dietitians, clinical psychologists, and specialty physicians, as well as those community-based organizations providing evidence-based health interventions, unable to deliver this important lifestyle intervention.

Unfortunately, Medicare beneficiaries do not have access to all evidence-based treatments for obesity, such as AOMs. When Medicare Part D was passed in 2003, it included language that restricted coverage of “weight loss” medications. Medicare has wrongly interpreted this restriction as a full exclusion. Because of this error, Medicare Part D continues to preclude older Americans, including dual eligible beneficiaries, from receiving updated, safe, and effective clinical standards of care reflecting FDA-approved pharmacotherapy to treat obesity. These restrictions are often simply copied in Medicaid and private insurance plans.

The members of OCAN support and endorse the Treat and Reduce Obesity Act. Obesity is the number two cause of preventable death in the United States and it is critical that Congress pass this important legislation to improve and save patient’s lives—now and into the future.