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ACS Governor Recounts Efforts to Address Disparities in Obesity Surgery in Texas
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 the respective ACS Chapters and the American Society of Metabolic and Bariatric Surgery, the ACS shared the ACS Bariatric Surgery Coverage Toolkit to help frame the salient issues surrounding our requests.
The College 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. The expansion of the Well Texas Program (Medicaid) to cover bariatric surgery also was discussed.
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. The discussion emphasized that obesity surgery is an effective therapy, and there is a need to address the discrepancies in access to care to help all Texans.
Getting Involved
Disparities in healthcare face every level of surgical practices, and ACS Fellows have an ethical responsibility to advocate for their patients and profession. Although taking time away from busy clinical practices can be difficult, spending time with legislators is necessary to address patient health. The ACS strongly encourages members to get involved in their ACS chapter and engage their respective legislators via lobby days and other advocacy efforts.
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