Viewpoint: Let’s pass TROA

Monica Lindeen

As a former Montana State Auditor & Commissioner of Securities and Insurance, I have seen firsthand the devastating impact that obesity can have on individuals and families. One thing that Congress can do right now to address skyrocketing health care and health insurance costs is pass the Treat and Reduce Obesity Act (TROA), which would update Medicare to cover evidence-based obesity treatment medications.

Obesity is a complex issue that affects millions of Americans. It can lead to various health problems, like diabetes, cancer, and heart disease. It also puts a significant strain on our healthcare system, costing billions of dollars each year in medical expenses and lost productivity.

Approximately 42% of adults in the U.S. are living with obesity, and the number continues to grow. By 2030, the rate is expected to rise to nearly 1/2 of all adults. The National Institutes of Health (NIH) has reported that obesity and being overweight are now the 2nd leading cause of death nationally, with an estimated 500,000 deaths a year attributed to excess weight.

 Over half of Medicare beneficiaries are treated for five or more chronic conditions per year. According to the Centers for Disease Control and Prevention (CDC), about 41% of adults aged 60 and over had obesity from 2015 through 2016, representing more than 27 million people. Medicare spends about $50 billion per year on obesity-related diseases. On average, a Medicare beneficiary with obesity costs $2,018 (in 2019 dollars) more than a healthy-weight beneficiary.

Innovative anti-obesity medicines are delivering never-before-seen improvements for people living with obesity.  Lifestyle interventions are often insufficient to help people achieve and sustain weight loss. Research has also proven that weight loss reduces obesity-related complications, improves physical functioning, offers mental health benefits, prevents future healthcare costs, and improves well-being.

Medicare covers treatments for other chronic diseases, including diabetes, prediabetes, arthritis, heart disease, chronic kidney diseases, and hypertension, yet does not cover the full spectrum of care for obesity as a chronic disease. TROA would modernize Medicare Part D to align with today’s medical understanding of obesity as a chronic disease, and passage will set the standard for the availability and continuity of effective treatment.

A subset of people who live with obesity and are appropriately treated with anti-obesity medicines will age into Medicare and be denied those medications unless Part D is updated to include coverage of anti-obesity medicines.

TROA has broad bi-partisan support and strong support from medical and patient communities. The bill updates access to comprehensive, affordable, and clinically effective treatments, allowing healthcare providers and Medicare beneficiaries access to all tools to treat obesity.

This bill is vital to Americans and Montanans as health insurance companies model their covered health benefits to reflect coverage to Medicare beneficiaries. That means that passing TROA may lead to increased obesity care coverage for Americans.

I urge our Montana Congressional Delegation to pass the Treat and Reduce Obesity Act. This bill has the potential to make a real difference in the lives of millions of Americans and to improve our nation's health.

Monica J. Lindeen served 8 years as Montana State Auditor and served in the Montana Legislature.