"An Act relating to the Gastric Bypass Insurance Coverage; and providing for an effective date."

HB 346 would require insurance companies to cover gastric bypass surgery if it is a medical necessity. Obesity is estimated to be responsible for approximately 300,000 deaths per year and the United States. Between 1991-2001 obese and overweight increased 32% for female adults in Alaska and 22% for men. Results from a study of 1200 physicians indicated poor obesity management practices (American Health Foundation and Academic Press 1997). Less than 20% of physicians reported that they would discuss weight management with overweight patients.

Some of the most common illnesses associated with obesity and overweight persons, as identified by Duke University Health are as follows:

1. Hypertension and Cardiovascular Disease.
2. Diabetes Mellitus Type 2
3. Obstructive Sleep Apnea
4. Gallstones

Some co morbidities (Medical conditions that occur simultaneously) (Also identified by Duke University.) associated with obesity are as follows:

Crippling arthritis and aggravation of prior joint injuries, which sometimes restricts the ability to work. Morbidly obese patients suffer real psychological stresses from ridicule, prejudice on the job, and limited access to public conveniences, and limitation of social activities. Overall, obese persons have much higher incidences of depression and suicide than those of people with a BMI (Body Mass Index) falling within the "normal" Classification.

The National Institutes of Health cite in a 1999-2000 survey estimates the total direct and indirect costs of treating individuals with illnesses attributable to their being overweight and obese at nearly $117 billion annually. While estimates vary, all sources agree costs are substantial and growing rapidly.

Candidates for surgery generally include only those patients with a BMI of 40 or higher, or those with a BMI of 35 or more who suffer obesity-related co-morbidities. Today Gastric bypass surgery generally costs between $ 15,000 and $ 25,000. There is wide spread agreement that with the weight lose associated with the procedure comes drastic improvement in obesity-related co morbidities. Specifically, over 70% of patients with hypertension and over 90% of patients with type two diabetes mellitus are able to discontinue medication shortly after surgery. Essentially, nearly all illnesses related to obesity are drastically improved, if not completely resolved by the weight loss.

In closing the general consensus appears to be that the risks of obesity are likely greater than gastric bypass surgery. There are currently four states, Georgia, Indiana, Maryland and Virginia with laws mandating insurance coverage of treatments of morbid obesity. Lawmakers in at least one other state (Ohio) are currently considering mandating coverage of gastric bypass surgery for the clinically obese.

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