Op-Ed: NC Medicaid must continue covering anti-obesity mediation
By Robbie Holland
In August 2024, NC Medicaid announced that it would begin covering anti-obesity medications (AOMs) for the treatment of obesity. As one of the states hardest hit by the obesity epidemic, the decision to cover AOMs was a major step in the right direction as the state looks to better treat obesity.
Across our state, 45 percent of residents are affected by obesity and by 2030, the overall rate could eclipse 50 percent. Among the minority and lower income populations that populate the Medicaid rolls, the rates are even higher and continuing to rise.
The toll of this crisis is staggering.
Annually, obesity is responsible for more than half-a-million deaths and more than $17 billion in statewide healthcare costs and lost worker productivity. The reason – it’s connected to 230 serious medical conditions, including heart disease, diabetes, high blood pressure, and 13 different types of cancer.
Obesity is the strongest predictor of hospitalizations and death after age. For those affected by the disease, in some cases, their mortality risk is increased by more than 90 percent.
Smartly, North Carolina recognized the threat of obesity and its various comorbidities. In announcing NC Medicaid coverage of AOMs, the state recognized the effectiveness of the drugs in both reducing weight and the risk of these other serious chronic diseases.
Now, however, this coverage is at risk of disappearing as the Legislature and Governor negotiate a final budget. While all sides have yet to come to an agreement, the House version of the budget that recently advanced out of that chamber proposes eliminating this coverage.
That would be the wrong move to make for a few reasons.
First, the state can either pay for obesity care now or they can pay later in the form of increased hospitalizations, doctors’ visits, and treatment for comorbidities. NC Medicaid currently spends approximately $1 billion on obesity-related healthcare expenses annually – expenses that would be certain to rise if AOM coverage was eliminated.
Aon recently released a research study that showed a seven percent decrease in medical costs after just two years of AOM usage. Reversing course now, approximately a year from when those initial savings will materialize and begin to grow, will only guarantee higher costs later.
Second, this would directly impact the long-term health of our state’s most vulnerable residents. After just two years of treatment, an AOM user sees their risk of hospitalization from a cardiovascular event drop by more than 40 percent.
And those affected by obesity face more risk of developing serious conditions, such as depression, cancer, diabetes, and many more. Eliminating coverage now puts Medicaid enrollees back on the path toward poor health outcomes, which in turn raises healthcare costs.
Lastly, this would be effectively pulling the rug out from Medicaid patients who are currently using these medications. This would strip away coverage for lifesaving medications from the residents of North Carolina who need it the most and are currently benefitting from access to them.
Healthier residents mean a stronger North Carolina. When people affected by obesity can access effective treatment, they're more likely to remain employed, contribute to their communities, and avoid the cascade of expensive complications that untreated obesity brings.
The calculus is simple – maintain coverage of AOMs now under NC Medicaid to reduce costs and improve health for vulnerable residents in the years to come.
It isn't just good healthcare policy; it's smart fiscal policy. And our lawmakers need to fight to protect it.
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