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Obesity Battle: Proposed law would require group health insurance plans cover treatment

Obesity is becoming a global health crisis, and the costs for treatment are staggering.

Paying out of pocket costs is not an option for many patients. But now a state senator from San Antonio is working to prevent that by helping Texans live a healthier lifestyle.

Obesity a daunting diagnosis that Trinidad De Los Santos can't afford to ignore.

I've tried every shake, tea and weight loss pill,” said Trinidad.

Here in Texas, nearly one in three adults is considered obese. That number expected to double by 2030.

“Working out in the field as a nurse I see it,” Trinidad explained. “I see the ramifications of what comes with the diseases that come with being obese, the high blood pressure, the diabetes, vascular issues.”

The San Antonio mother of two says diabetes runs in her family. After years of failed attempts to lose weight, Trinidad looked into bariatric surgery. But she found out her employer's health insurance does not cover weight loss procedures.

“This is one of the last resorts for me to try and lose weight,” said Trinidad.

“San Antonio is one of the worst places actually in Texas,” Dr. Mickey Seger told us.

Dr. Seger performs bariatric surgeries at Methodist Specialty and Transplant Hospital.

He says out of pocket costs for weight loss procedure runs between $13,000 to $20,000.

“Every day somebody, leaves my office that cannot afford this, cannot find a way to get it done,” said Dr. Seger. “And they do not have the coverage, despite having a normal regular otherwise good insurance plan.”

If left untreated, obesity often leads to serious medical conditions like heart disease and diabetes. Each year, Texas businesses spend more than $11 billion for obesity-related medical claims, employee sick days and lower productivity. The cost of obesity gets passed on to everyone through higher insurance premiums.

“Certainly as a surgeon, we want to try everything on the medical side beforehand,” Dr. Seger said.

Twenty-three states now have specific healthcare requirements to cover bariatric procedures. Texas does not.

“I'm really excited to be working with State Senator Jose Menendez with this legislation,” said Dr. Seger.

That's why Dr. Seger is pushing for Texas lawmakers to recognize obesity as a serious health issue.

“I'd like to see the state of Texas see this as a real problem,” explained Senator Menendez.

Last week Senator Menendez filed a bill that would require group health insurance plans to cover obesity treatment.

“Primarily, the best thing would be preventative, counseling, nutritional specialist, some way they can help people prevent obesity or deal with it naturally.” Senator Menendez told us.

Beyond preventative measures, Senate Bill 756 also includes medications and more extreme measures-- like bariatric surgery.

“I know people are going to say ‘Well, if you include this as part of the insurance, it's going to raise the cost of insurance,’’ said Senator Menendez. “I think that in the long run by helping people not become obese, the cost will be lower to all of us.”

For Trinidad, it's not just a lifestyle.

“I still have two boys to raise,” said Trinidad.

It's a lifeline for her family.

“I never give up,” Trinidad told us. “It's an ongoing battle been there for years, but I never give up.”

Senate Bill 756 is expected to be referred to committee sometime this week. For more information, you can track the bill on the Texas Legislature website.


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