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Weight-loss bill faces uphill battle

Apr 16, 2008 | KEVIN LANDRIGAN | Nashua Telegraph News

Business leaders, insurers, a medical expert and a primary opponent all ganged up on the proposal of Sen. Robert Clegg, R-Hudson, that would require insurers to cover the cost of weight-loss surgery.

Clegg retold his personal story of having to pay more than $20,000 out-of-pocket in September for a gastric bypass procedure after a Boston doctor concluded he was a cancer and hypertension risk.

"In essence my body was killing itself. I am not unique,'' Clegg told the House Commerce Committee on Tuesday at the final hearing of the bill.

Gastric bypass surgery reroutes the gastrointestinal system and is the preferred form of weight-loss surgery. Another option is the installation of a band that constricts the size of the stomach.

Doctors advised Clegg to have the bypass because it also would correct problems with his metabolism.

Clegg decided to pursue the measure after learning his family health insurer, Cigna Health Care, would not cover the procedure.

Elizabeth Murphy, Cigna's lobbyist, said the insurer covers the surgery in some, but not all, of its insurance plans. Mandating it as a benefit on all policies will raise premiums, she said.

Clegg is seeking the Second Congressional District nomination, and fellow Republican congressional candidate Grant Bosse, who attended the hearing, claimed this policy would raise health-care costs.

"SB 312 is compassionate and it is well-meaning. but it is a tremendously bad idea,'' Bosse said. "We can't regulate our way to lower health-care costs.''

State workers can get this surgery coverage through an option offered by their insurer, Anthem Blue Cross of New Hampshire.

But Mark Vattes, an Anthem lobbyist, said the mandate would limit cheaper coverage options for employers.

"We feel philosophically that by mandating the procedure across all product lines, you are limiting the choice that employers have,'' Vattes said.

Richard Lafleur, Anthem's medical director, said the procedure is too new to know the long-term impacts. He cited recent studies that concluded that while the surgery improved diabetic symptoms, it did not alter risks from high levels of cholesterol or blood pressure.

"Do we truly understand what surgery is the right thing at the right time? Lafleur asked.

Rep. Lee Quandt, R-Exeter, a Clegg supporter, said the real fight for this may lie before the full House.

"I think we can make a compelling case that this costly surgery in the end would lower medical costs by improving health and reducing the risk of worker injuries,'' Quandt said.

"It looks like the leadership in both parties may be opposing this, but that can be overcome.''