title: Obesity coverage gap: Consumers perceive low coverage for obesity treatments even when workplace wellness programs target BMI.
abstract: Evidence-based obesity treatments, such as bariatric surgery, are not considered essential health benefits under the Affordable Care Act. Employer-sponsored wellness programs with incentives based on biometric outcomes are allowed and often used despite mixed evidence regarding their effectiveness. This study examines consumers' perceptions of their coverage for obesity treatments and exposure to workplace wellness programs.
  
  
  
  A total of 7,378 participants completed an online survey during 2015-2016. Respondents answered questions regarding their health coverage for seven medical services and exposure to employer wellness programs that target weight or body mass index (BMI). Using χ2tests, associations between perceptions of exposure to employer wellness programs and coverage for medical services were examined. Differences between survey years were also assessed.
  
  
  
  Most respondents reported they did not have health coverage for obesity treatments, but more of the respondents with employer wellness programs reported having coverage. Neither the perception of coverage for obesity treatments nor exposure to wellness programs increased between 2015 and 2016.
  
  
  
  Even when consumers have exposure to employer wellness programs that target BMI, their health insurance often excludes obesity treatments. Given the clinical and cost-effectiveness of such treatments, reducing that coverage gap may mitigate obesity's individual- and population-level effects.
authors.affiliation: Harvard Kennedy School, Cambridge, Massachusetts, USA.
authors.forename: Elizabeth Ruth
authors.initials: ER
authors.lastname: Wilson
authors.affiliation: ConscienHealth, Pittsburgh, Pennsylvania, USA.|Obesity Action Coalition, Tampa, Florida, USA.
authors.forename: Theodore K
authors.initials: TK
authors.lastname: Kyle
authors.affiliation: Obesity Action Coalition, Tampa, Florida, USA.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Nadglowski
authors.affiliation: Massachusetts General Hospital-Department of Medicine-Gastroenterology, MGH Weight Center, Harvard Medical School, Boston, Massachusetts, USA.|Department of Pediatrics-Endocrinology, MGH Weight Center, Harvard Medical School, Boston, Massachusetts, USA.
authors.forename: Fatima Cody
authors.initials: FC
authors.lastname: Stanford
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015992:Body Mass Index; D005260:Female; D006293:Health Promotion; D006801:Humans; D007348:Insurance, Health; D008297:Male; D008875:Middle Aged; D009042:Motivation; D009765:Obesity / Q000628:therapy*; D058991:Patient Protection and Affordable Care Act; D010465:Perception; D011795:Surveys and Questionnaires; D014481:United States; D017132:Workplace; D055815:Young Adult