By Sara Schmitt

As Coloradans launch their New Year’s diets, with a good percentage of them destined to fail, it’s worth noting that the federal Affordable Care Act requires — for the first time —that insurance companies cover obesity screening and management without cost-sharing.

Of the roughly 610,000 obese Coloradans with health insurance, many may now be eligible to sign up for treatment programs without co-pays. The health reform law requires that Medicare as well as most private insurance companies, including employer self-insured plans, cover the cost of these services for in-network providers. (Many insurance plans, however, are exempt because of a grandfathering clause.)

It’s a good bet that many eligible Coloradans are unaware of the change.

Historically, many insurers did not cover treatment for obesity. The Affordable Care Act’s Preventive Services Regulations, generally referred to as the Preventive Mandate, remove cost-sharing requirements – co-pays and deductibles – for those with health insurance for a number of proven preventive services, including counseling to quit smoking and obesity treatment.

Research has shown that removing cost-sharing requirements is a strong incentive for patients to use preventive services. In addition, engaging insurance companies, health care providers, employers and educators — the health care system — as more proactive players in addressing the growing obesity epidemic can be a positive step.

As with any attempt to address obesity, the challenges are many. Obesity requires multiple treatment options and a patient who is ready to make a personal commitment. Today’s health system and payment models aren’t necessarily structured to provide effective interventions. The new guidelines cover only those who are already obese rather than those who are overweight and could be prevented from crossing the line into obesity. And Colorado may not have enough qualified providers to deliver or coordinate multi-component behavioral interventions.

Only time will tell, meanwhile, whether the initial higher costs to provide the increased coverage will result in healthier patients at more appropriate weights — and lower overall health care costs — down the road.

There are important reasons to investigate new options in treating more people for obesity.

Obesity is a growing concern for Colorado. Although Colorado has the lowest rate of adult obesity among the states, our rate has doubled in the past 15 years, reaching 20.9 percent in 2011. That means one of every five Coloradans is obese, with a body mass index (BMI) of 30 or above. About 13 percent of Colorado’s children are obese, a worrisome trend.

Obesity is linked to many preventable diseases such as heart disease and diabetes. It is also expensive. Obesity-related medical issues cost an estimated $1.6 billion in Colorado in 2009, with almost half spent by Medicare and Medicaid. Obese individuals rack up $1,429 more each year in medical costs than those of normal weight.

Addressing obesity is not easy. An estimated 50 million Americans go on a diet each year, with just five to 20 percent of them successfully maintaining weight loss.

Leaders across Colorado recognize that obesity is more than a personal issue. Public health agencies, private foundations and not-for-profit organizations are working together to reduce obesity in communities. The Colorado Department of Public Health and Environment lists fighting obesity as one of its 10 “winnable battles.”

Meanwhile, several community organizations will offer the Diabetes Prevention Program beginning this year. Health plans, large employers and health systems have teamed to make the lifestyle-change program available.

Together, these efforts can build awareness and address the significant challenges facing Colorado.  The new opportunities for treatment included in the health reform law represent an additional weapon in the battle.

Sara Schmitt is director of community health policy for the Colorado Health Institute. Her brief, “Obesity Treatment: A New Strategy to Address a Growing Problem” is available at: http://coloradohealthinstitute.org/uploads/downloads/CHI_Obesity_Brief.pdf