Medicaid and the obesity population

July 13th, 2016 No comments »

A recent study indicates that midlife obesity predicts nursing home admissions. This could be critical for Medicaid which pays the majority of nursing home costs.  Overweight was not associated with greater nursing home admissions. Discrimination may be the reason. See post. Recent data show a 24.2% of nursing home residents take antipsychotic medications which can cause weight gain. 5.8% or residents show unintended weight loss.

2016 State Medicaid coverage of fee-for-service obesity treatments

May 2nd, 2016 No comments »

The STOP Obesity Alliance has updated its state-by-state information on fee-for-service obesity treatments in the Medicaid program. See here.

Something To Be Grateful For

November 25th, 2015 No comments »

Modern HealthCare magazine reports that Mississippi is planning to add bariatric surgery to its Medicaid program, citing research from the STOP Obesity Alliance.

Puerto Rico Does Not Have the Answer

February 14th, 2015 No comments »

I’m sorry. There, I said it. I was wrong. In 2008, a Mississippi legislator proposed that restaurants should be prohibited from serving customers who were obese. In a USA Today article, I called the bill “the most ill-conceived plan to address a public health crisis ever proposed.” I was wrong. Puerto Rico legislators are going one better. (See Ted Kyle’s post.)They are proposing to impose a fine on parents of children with obesity. Yes, a fine. Oh, that will help! “Parents: Starve your children and you save a few bucks!” Wow, what a deal! That will overcome the cries of hungry children.

This kind of proposal is easy to shoot down. However, it reflects a grave public policy problem. Most of the public policy debate is now dominated by behavioral economists who only see incentives and penalties as valid interventions. They disregard any contribution of biology in their research. Some may see the contribution of the environment. However, their recommendations trend to changing individual behavior, not in environmental changes. That leaves the only option for policy-makers, led on by behavioral economists, to propose ever more and more brutal penalties on persons with obesity (such as the penalties on workers in ‘employer wellness’ programs) or, in this case, on the parents of children with obesity.

The origins of this kind of policy direction lie not in Puerto Rico. A prominent obesity researcher and clinician David Ludwig called on state child protective services to take children with obesity away from their parents. It used to be that political thought was opposed to visiting the sins of the father on his children. Behavioral economists have turned this inside out to visit the parent with the ‘sin’ of the children, in this case, being overweight. This is public policy madness  which will not solve the obesity problem but only put off any real, grown-up policy development.


Update on State Medicaid Expansion Under Obamacare

February 8th, 2014 No comments »

State ReforUM tracks state-level health care reforms. Check out their updated map of what states are doing in expanding Medicaid, pursuant to the Affordable Care Act (ACA). See the story on what South Carolina is up to.


South Carolina Tackles Obesity in Medicaid Program

February 7th, 2014 No comments »

South Carolina’s The State newspaper reports that the state Medicaid program will start paying physicians and dieticians to treat obesity among the state’s Medicaid population. The State’s article states, “The anti-obesity coverage would pay for up to six visits a year with a physician and six visits with a licensed dietitian, a nutrition specialist who has a five-year degree who also is registered with the state. State officials estimate about 86,000 people, or 60 percent of South Carolina’s obese Medicaid recipients, would participate.

If 60 percent do participate, officials estimate that the cost to the state’s Medicaid program would be an extra $10.5 million. Most of that money would come from the federal government. However, $3 million would come from state taxpayers.

The state’s Medicaid agency has requested the taxpayer money. But even if lawmakers reject that request – unlikely given the support of Haley and legislative Republicans and Democrats – the agency says it still will start the program by cutting other programs in its budget.


Court Bans Bloomberg’s Ban

March 11th, 2013 5 comments »

The New York Times reports that a New York State Supreme Court judge has thrown out Mayor Mike Bloomberg’s ban on large size serving cups of sugar sweetened beverages. The judge apparently concluded that the statute was ‘arbitrary and capricious’ because other high calorie drinks were not covered and not all establishments selling beverages were covered.

The Court’s opinion states, “The simple reading of the Rule is nevertheless fraught with arbitrary and capricious consequences. The simple reading of the Rule leads to the earlier acknowledged uneven enforcement even within a particular City block, much less the City as a whole. Furthermore, as previously discussed, the loophole in this Rule effectively defeat the stated purpose of the Rule. It is arbitrary and capricious because it applies to some put not all food establishments in the City, it excludes other beverages that have significantly higher concentrations of sugar sweeteners and/or calories on suspect grounds, and the loopholes inherent in the Rule, including but not limited to no limitations on re-fills, defeat and/or serve to gut the purpose of the Rule.”

These problems with the law were easily foreseeable, as I wrote in Note to Mayor Bloomberg. The judge’s opinion also appears to reflect recent decisions of the Supreme Court which are likely to limit similar, broad approaches to obesity.



New State Research from STOP Alliance

December 14th, 2012 No comments »

The STOP Obesity Alliance has released its “Weight and the States”, a policy research bulletin. The December 2012 edition focuses on key obesity-related trends in 2012 and forecasts those emerging in 2013. Key findings relate to Essential Health Benefits provision of the Affordable Care Act and improving food and physical activity environments.