Opinion: Expanding Coverage for Chronic Obesity Treatment is Investing in Health

By Representative Jane Gillette (R-Three Forks)

Representative Jane Gillette (R-Three Forks) official portrait

As a dentist in my professional life, I have the responsibility of making sure my patients maintain great oral health and overall health. I also have the tremendous honor of serving the Chair of Joint Subcommittee on Health and Human Services in the Montana legislature, which is responsible for making sure Montana taxpayer dollars are spent wisely helping our communities become healthier.

In both roles, I’ve seen firsthand devastating impacts of chronic obesity on Montanans, their families, and our healthcare system. We’ve dedicated countless resources to managing complications of conditions that come with chronic obesity rather than addressing the root cause. Of course, managing diet and exercise is an important component. With that said there are some who cannot use that approach alone. Accordingly, it’s time for a new approach that allows us to move towards preventative care that not only improves lives, but also strengthens our healthcare system. That's why I strongly believe anti-obesity medications (AOM’s), also known as GLP-1 drugs, should be covered under Medicare, Medicaid, and all other health plans.

AOM’s offer a transformative approach to managing chronic obesity while treating other diseases that come along with this deadly condition. Chronic obesity is a major risk factor for serious health conditions including cardiovascular diseases, type 2 diabetes, and even types of cancers.

The current approach to chronic obesity management focuses on treating existing conditions rather than tackling underlying issues. This reactive approach leads to escalating healthcare costs and diminished quality of life for millions of Americans. AOM’s offer a different path. These medications mimic a naturally occurring hormone that regulates blood sugar, promotes weight loss, and provides significant cardiovascular benefits.

AOM’s are not a replacement for healthy habits like diet and exercise; they are a powerful tool that compliment those efforts. They can help Montanans achieve and maintain the weight loss necessary to make lifestyle changes more effective and sustainable.

This multifaceted approach not only improves glycemic control, but it will also lead to clinically significant weight loss, a critical factor in managing and even reversing disease.

AOM’s are a game-changer. We can prevent life-threatening complications and save taxpayers billions of dollars. In fact, studies show that over the first decade, Medicare could save approximately $175 billion and increase to $700 billion in savings over the next 30 years. Even further, if all eligible Americans received treatment, society could realize annual savings of $100 billion (or $1 trillion over 10 years) through reduced healthcare expenditures and improved quality of life due to decreased disabilities and pain.

But there is a challenge. These medications are not inexpensive. We need to shift our perspective from short-term costs to long-term value. Consider the downstream costs of not covering these drugs. The cost of treating the complications of uncontrolled diabetes and obesity – the hospitalizations, the surgeries, the long-term care – dwarfs the cost of preventative medication.

That’s why I am calling on Montana’s senior senator, Senator Steve Daines, to support finalizing a CMS rule that would allow Medicare to cover FDA approved AOM’s. By having Medicare cover AOM’s, we are investing in chronic obesity prevention and deterring expensive and devastating consequences of the disease. We’ll be investing in healthier communities, and a healthier economy.

As the Chair of Joint Subcommittee on Health and Human Services and as a health care provider myself, I believe it’s time we prioritize innovation and invest in solutions that truly address the root cause of this chronic and debilitating disease. Expanding Medicare coverage for AOM’s is about reimagining our approach to chronic disease management. It’s about investing in prevention, improving health outcomes, and reducing long-term healthcare costs. It’s about empowering individuals to take control of their health and live longer, healthier lives.