[Congressional Record (Bound Edition), Volume 147 (2001), Part 5]
[Extensions of Remarks]
[Page 6466]
[From the U.S. Government Publishing Office, www.gpo.gov]



               THE MEDICAID OBESITY TREATMENT ACT OF 2001

                                 ______
                                 

                          HON. EDOLPHUS TOWNS

                              of new york

                    in the house of representatives

                        Thursday, April 26, 2001

  Mr. TOWNS. Mr. Speaker, in honor of National Minority Health Month, 
today I am introducing the ``Medicaid Obesity Treatment Act of 2001`` 
to elevate the visibility of a national health epidemic that is 
wreaking particular havoc upon our minority communities. For too long, 
obesity has escaped adequate attention from both policymakers, 
scientists and the general public. With this bill, which will simply 
provide Medicaid coverage for medically necessary treatments for 
chronically obese beneficiaries, I hope to raise the level of attention 
to this devastating illness. The Medicaid Obesity Treatment Act of 2001 
is the first legislation ever introduced in the Congress to 
specifically address the need to ensure access for all Americans to 
drug therapies designed to treat obesity and its related comorbidities, 
and I am proud to be its sponsor.
  Obesity has truly become a national health care crisis. The National 
Center for Health Statistics reports that 60 percent of Americans over 
20 years of age are overweight or clinically obese. Weight-related 
conditions represent the second leading cause of death in the United 
States, and result in approximately 300,000 preventable deaths each 
year.
  According to the Surgeon General, the prevalence of overweight and 
obesity has almost doubled among America's children and adolescents 
since 1980. It is estimated that one out of five children is obese. The 
epidemic growth in obesity acquired during childhood or adolescence is 
particularly threatening to the national health because it often 
persists into adulthood and increases the risk for some chronic 
diseases later in life.
  The prevalence of obesity in America is at an all time high, 
affecting every State, both men and women, all ages, races, and 
education levels. Disparities in health status indicators and risk 
factors for diet-related disease are evident in many segments of the 
population based on gender, age, race and ethnicity, and income. 
Overweight and obesity are observed in all population groups, but 
obesity is particularly common among Hispanic, African American, Native 
American, and Pacific Islander women.
  Too many Americans, particularly urban residents, have inadequate 
access to fresh produce and healthy food products. Too many Americans 
have desk jobs that afford them little opportunity to maintain adequate 
physical conditioning. And for too many Americans today, the most 
plentiful, available and affordable food is often the least nutritious.
  For years, obesity was considered a lifestyle choice. Now, however, 
it is increasingly understood to be an illness with serious health 
consequences. It is proven that overweight and obesity are associated 
with significantly higher mortality rates. Additionally, obesity 
substantially increases the risk of other illnesses, including breast 
cancer, colon cancer, ovarian cancer, prostate cancer, cardiovascular 
disease, high blood pressure, high cholesterol, type 2 diabetes, heart 
disease, stroke, gallbladder disease, arthritis, sleep disturbances and 
respiratory problems.
  The costs of obesity on the public health system are truly 
staggering. The total cost, both in terms of health care and lost 
productivity, of obesity alone was estimated as $99 billion in 1995. As 
it becomes more prevalent, obesity's toll on the national economy will 
only grow.
  There is some promising news, however. Science has made great strides 
in recent years to both understand and combat obesity. Several new 
drugs offer great promise in the fight to prevent and treat obesity and 
its related comorbidities.
  Unfortunately, however, coverage of these drugs is excludable under 
Medicaid due to an eleven year old provision that allows states to 
exclude weight loss drugs, even in cases where these drugs have the 
potential to save lives. This provision is based upon the outdated 
notion of obesity as a ``lifestyle choice'' and the notion of anti-
obesity medication as cosmetic in nature. These notions, and the 
provision based upon them, are no longer valid scientifically, and must 
be stricken from the law. Medically necessary medicine for the 
treatment of chronic obesity should be covered under Medicaid like any 
other medically necessary drug. This is the purpose and goal of this 
bill.




  Although this expansion in Medicaid coverage might incur some 
marginal cost to the overall program, requiring states to cover proven 
obesity medication may actually reduce Medicaid expenditures as a 
result of decreases in the costs associated with treating obesity-
related comorbidities such as diabetes and heart disease. Given the 
numerous collateral benefits of reducing obesity, in addition to the 
underlying treatment of obesity for the disease that it is, it makes 
good sense and good public policy to provide Medicaid beneficiaries 
access to life saving antiobesity medicines.
  Finally, as the Congress looks towards the formation of a 
prescription drug benefit for all Americans, we must be wary of simply 
importing the outdated notions implicit in Medicaid coverage 
definitions which might have the effect of denying access to medically 
necessary weight loss drugs. Any prescription drug benefit must provide 
coverage for medically necessary medications for chronic obesity 
consistent with its coverage of other medically necessary disease 
treatments.
  Obesity is a growing epidemic across the nation which must be 
addressed with more than just words. This bill offers an important 
first step towards stemming the tide against this preventable killer. 
During this year's observance of National Minority Health Month, I am 
pleased to introduce this bill to both highlight the epidemic of 
obesity, which strikes particularly hard in the minority community, and 
to do something substantive about it. I encourage my colleagues to join 
me in supporting it.

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