At the Texas State ACS Chapter Advocacy Day, held February 23, I joined Linda Dultz, MD, FACS, Advocacy Chair of the North Texas ACS Chapter, and Robert Carpenter, MD, FACS, Advocacy Chair of the South Texas Chapter, to address the healthcare disparities in obesity surgery affecting the medical system in Texas. This is a critical issue, as 35.7% of Texans are obese.
A 2020 Texas Department of Health and Human Services Report indicated obesity (BMI >30 kg/m2) affects 41.2% of Black Americans, 40.3% of the Latinx population, and 32.5% of White residents.
Socioeconomically, 40.4% of obese Texans have a household income of less than $35,000; 44.5% have less than a high school diploma; and 40.4% have no healthcare coverage. The impact on the workforce is staggering, as 77.2% of obese Texans are under the age of 65, with comorbidities and illnesses that limit their years of productivity.
Raising Awareness
To educate Texas state legislators about our respective ACS Chapters and the American Society of Metabolic and Bariatric Surgery, we shared the ACS Bariatric Surgery Coverage Toolkit to help frame the salient issues surrounding our requests. We encouraged the Senate, House of Representatives, and the General Assembly to identify ways to augment coverage in coordination with insurance carriers—primarily Medicaid—to include bariatric surgery. We also discussed the expansion of the Well Texas Program (Medicaid) to cover bariatric surgery.
Discriminatory benefits regarding bariatric surgery currently exist in several states such as California, Michigan, New Mexico, New York; there are higher copays and deductibles, limits on types and numbers of surgeries based on expected outcomes, and discriminatory insurance policy clauses, including violations of the Affordable Care Act by establishing limits on care. Our discussion emphasized obesity surgery is an effective therapy and the need to address the discrepancies in access to care to help all Texans.
Getting Involved
Disparities in healthcare face us at every level of our surgical practices, and, as Fellows, we have an ethical responsibility to advocate for our patients and profession. Although taking time away from our busy clinical practices can be difficult, spending time with legislators is necessary to address the health of our patients. We strongly encourage you to get involved in your ACS chapter and engage your respective legislators via lobby days or other advocacy efforts.
