Chukwuocha: Congress must pass Treat and Reduce Obesity Act
Rep. Nnamdi Chukwuocha is a Democrat serving Wilmington.
There’s no way around it: The obesity epidemic is an urgent public health crisis that affects millions of Americans. According to the Centers for Disease Control and Prevention, more than 40% of adults in the U.S. are obese, a figure that has steadily risen since the agency first declared obesity to be an epidemic a quarter of a century ago. Despite this alarming trend, the obesity epidemic has been consistently overlooked by policymakers. When the broad range of associated comorbidities, such as diabetes, heart disease, stroke and certain cancers, are taken into account, it becomes all the more evident that this epidemic places a burden on our health care system. Thankfully, obesity in America has not been completely ignored, as Sen. Tom Carper, D-Del., has consistently led the charge against the epidemic in Congress, through the Treat and Reduce Obesity Act. The measure, first introduced in 2021 and reintroduced in 2023, is bipartisan legislation that would ensure that patients who have existing coverage of Food and Drug Administration-approved antiobesity medications will not lose coverage when they enroll in the Medicare program. In July, the legislation was released from the Ways & Means Committee.
While this current version of TROA is parsed down from its original form, which expands Medicare Part D to cover these medications, it is still a step in the right direction. Put simply, a vote against this bill is a vote against older adults suffering from obesity. Current law discriminates against obesity treatments by statutorily preventing Medicare from covering AOMs for weight loss, which is an unprecedented practice. The exclusion is outdated, as well, as the science behind antiobesity drugs has advanced rapidly in the past few years. One recent study has shown that certain medicines can reduce the risk of cardiovascular diseases linked to obesity by up to 20%. On top of that, the University of Southern California’s Leonard D. Schaeffer Center for Health Policy & Economics has projected that expanding access to AOMs is estimated to have an offset worth $175 billion in Medicare spending within the first decade. Expanding access to such medication through Medicare Part D is a simple solution that could save millions of lives and trillions in spending over the course of a few decades.
While this version of the Treat and Reduce Obesity Act is not a permanent solution for all seniors, it can bring about a critical change for patients who currently have coverage of antiobesity medications. The denial of access when they enter Medicare subjects them to a lower standard of care than other insured patients and disrupts the continuity of their care, ensuring regression in their battle against obesity. Plus, the bill addresses longstanding equity issues. According to a 2019 study by the New England Journal of Medicine, nearly 1 in 2 adults will be obese by 2030. These rates are even higher for communities of color, with almost half of Black and Latino adults now suffering from obesity. The legislation requires the Medicare Payment Advisory Commission to study and present data to understand how to best address and provide care for underserved populations, which is a long overdue action. Additionally, TROA addresses unmet needs in intensive behavioral therapy by expanding the provider network.
America now sits at an inflection point for our collective health, and we need our leaders to take decisive action to help combat the obesity epidemic. Without this legislation, low-income and/or disabled patients in states that have Medicaid coverage will lose access to this important medicine that is greatly improving their health when they enroll in Medicare. Congress needs to ensure that the most vulnerable seniors are not penalized simply for enrolling in Medicare. The bottom line is that supporting the Treat and Reduce Obesity Act is a critical first step in ensuring that all Medicare beneficiaries living with obesity have access to comprehensive treatment options.
Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.
