(NewsNation) A Washington state nurse has filed a class-action lawsuit, claiming the state agency responsible for providing health insurance to public employees discriminates against those who struggle with obesity by neglecting to include weight-loss medications in its coverage.
Insurance companies do not routinely cover these medications like Ozempic, Wegovy, and Mounjaro when prescribed for obesity. Many patients find themselves saddled with daunting costs, often exceeding $1,000 per month.
Jeannette Simonton, the plaintiff behind the lawsuit, has explored many avenues to combat her weight.
She lost 80 pounds using the drug Wegovy. The weight loss significantly improved his quality of life, allowing him to engage in previously difficult activities.
However, his insurance does not cover medications.
“It’s been so disappointing. Because I feel like they’re looking at me like I’m in a box. I’m checking a stat in a box, Simonton said.
Simonton physician Peter Billing said weight-loss drugs like Ozempic and Wegovy are key to treating obesity, a medical condition with well-established biological markers.
This is simply discriminatory against obese people, and it is completely wrong. It is a medical disease caused by high insulin secretion. We show it in the labs we draw, Billing said.
Simonton and her attorney, Ele Hamburger, claim insurers discriminate against obese people.
After the Affordable Care Act and with similar state laws, health insurance companies are no longer legally allowed to discriminate based on disability or serious health conditions.
The focus should be on the medical effectiveness of the treatment, and given the scientific consensus supporting the effectiveness of these weight-loss drugs, exclusion appears to be a form of discrimination, according to Hamburger.
Billing said there is a misconception that treatments are simply cosmetic rather than medical.
The idea is that people are obese because they are lazy. They don’t reduce what they eat or exercise. That couldn’t be further from the truth, Billing said.
Being overweight or obese can have serious health consequences. Carrying extra fat leads to serious health consequences, such as cardiovascular disease (primarily heart disease and stroke), type 2 diabetes, musculoskeletal disorders like osteoarthritis, and some cancers (endometrium , breast and colon), according to the World Health Organization.
Although diet and exercise are effective for some, severe obesity requires more robust intervention, according to Billing.
Washington state law designates obesity as a protected disability, although this guarantee is not universal in all states.
The science is so clear that the only reason to continue to exclude this type of treatment is discrimination. This is discrimination based on disability, Hamburger said.
In a country with more than 100 million clinically obese people, a pressing question arises: Should health insurance providers foot the bill for weight-loss drugs?
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