Act 109 qualifies state, public school employees for transformative weight loss surgery

by Dr. Samuel Bledsoe ([email protected]) 2,236 views 

According to the Centers for Disease Control (CDC), 36.4% of Arkansans struggle with obesity, ranking our state as the ninth-worst in the rate of obesity. That’s 1,103,155 people who fall into the highest weight category, increasing their risk of severe health complications and diseases, including diabetes, heart disease, stroke and cancer. And as moms, dads, friends and employees, it’s time we find a solution to help transform their health outcomes.

Thankfully, our state leaders recognized the severity of this nationwide epidemic more than 11 years ago and have been dedicated to finding a solution.

In 2010, a state analysis proved that the annual total medical costs for those categorized as morbidly obese were 54% higher than those listed as “no risk,” or not obese or at an ideal weight for their height. And based on research by the National Institutes of Health, the American Society for Metabolic and Bariatric Surgery, the American Obesity Association and Shape Up America, we know that morbid obesity leads to extraneous expenses that can be resolved should the patient have access to weight loss surgery.

In light of these findings, the state launched a pilot program in 2011 that allowed a limited number of state employees to undergo weight loss surgeries under their health plan.

In 2019, the program participants who had bariatric surgery had a total per-member per-month cost reduction of 37%, primarily due to a reduction of 45% in medical per-member per-month costs.

The program demonstrated surgical intervention was a far more cost effective approach than traditional medical interventions.

In March 2022, the Arkansas legislature passed Act 109, establishing coverage for diagnosing and treating morbid obesity under the State and Public School Life and Health Insurance program. Effective January 1, 2023, weight loss surgery is available for state and public school employees.

The coverage will include gastric bypass surgery, adjustable gastric banding surgery, sleeve gastrectomy surgery and duodenal switch biliopancreatic diversion. It’s expected that payers can expect bariatric surgery to pay for itself through fewer comorbidities, decreased medication usage and declining hospitalization rates within two to four years.

So what now?

The coverage goes into effect in January and I strongly encourage these newly eligible Arkansans to start considering if weight loss surgery is right for them. From the first exploratory conversation through the surgery date, the process takes around two to six months, so it’s never too early to start your research.

The Bariatric and Metabolic Institute at Arkansas Heart Hospital was recently named a Comprehensive Center by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program, a joint Quality Program of the American College of Surgeons (ACS) and the American Society for Metabolic and Bariatric Surgery (ASMBS). We have on-demand seminars available online at this link.

Editor’s note: Dr. Samuel Bledsoe is a bariatric surgeon at the Bariatric and Metabolic Institute at Arkansas Heart Hospital. The opinions expressed are those of the author.