Rosemarie Biancardi

Legislative and regulatory Initiative assignments

Treat and Reduce Obesity Act 2015
History and Background
The nonpartisan congressional budget office (CBO) released a report in 2010 that
showed alarming figures related to obesity in the United States. 1,2 The report showed that
the obesity rate had increased from 13 to 28 percent between the years 1987 to 2007.1,2
They also reported that obesity was also increasing health spending; due to comorbidities
related to obesity.1,2 Currently, approximately 68.5% of adults and 31.8% of children are
considered to be overweight or obese in the United States.3 More specifically about 35%
of the 68.5% of those individuals are obese.1,2,4 With Obesity rates increasing rapidly
there has also been an increase in healthcare spending.1,2 Obesity is currently costing the
United states about 210 billion dollars per year. 1,3Medicaid and Medicare alone are
responsible for $61.8 billion dollars of the 210 billion.1,2 This is due to the comorbidities
that accompany obesity and not obesity itself. 1 If an individual is obese there risk of
developing high blood pressure, diabetes, heart disease and other chronic disease will
increase when comparing to a person who has a healthy weight. 1,2
According to the Congressional Research service approximately half the
Medicare eligible population will be considered obese by 2030.1,2 According to the CDC
an individual that is obese on Medicare costs about $2,000 more dollars more compared
to an individual with a normal weight. 1,2 Seeing these figures makes it evident that there
needs to be more weight management options for this population.4 The Treat and Reduce
Obesity Act will make it possible for the Medicare population to have easier access to

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practitioners, including dietitians, that treat obesity with intensive behavioral therapy and
with FDA approved weight loss medications at a lower cost. 1,2,4
Current Legislative and/or Regulatory Initiatives
The Treat and Reduce Obesity Act (H.R 2415, S.1184) was introduced to the 113th
congress in 2013.5 The treat and Reduce obesity Act did have some support from the
House and the Senate and also 121- cosponsors.5 Although it did not make it past the
committee level.5 Senators Carper (D-DE), Cassidy (R-LA), Coons (D-DE), Grassley (RIA) Heinrich (D-NM), and Murkowski (R-AK) and Representatives Kind (D-WI),
Paulsen (R-MN) reintroduced the Treat and Reduce Obesity Act in 2015.5 The Reduce
and Treat Obesity Act (H.R 2404 S. 1509) was introduced to the House on 5/18/15 and
was introduced to the Senate on 6/04/15.5 The treat and Reduce Obesity Act amends title
XVIII of the Social Security Act to authorize the Department of Human Health Services.6
This Act would allow seniors that have Medicare to get comprehensive treatment for
obesity.1,2 The Reduce and Treat Obesity Act would give the Center for Medicare and
Medicaid services could modify their benefits so other health care providers could
provide behavioral counseling.1,2,4,7,8 This would allow registered dietitians nutritionists to
intensive behavioral therapy to individuals with Medicare. 4,7,8The other part of the
Reduce and Treat obesity Act is coverage of obesity drugs.1,2 This would allow CMS to
provide coverage for FDA approved prescription drugs under Medicare part D if they
have a BMI of 30 or higher or a BMI of 27-29.9 with one comorbidity.1,2 The aim of this
act is to reduce barriers for individuals on Medicare to receive treatment for their
obesity.1,2,4 The Estimated savings of covering FDA approved weight management drugs
under Medicare part D would be 11,400 for females and $113 for males under Medicare.7

Rosemarie Biancardi
The Reduce and Treat Obesity Act not only reduces barriers for individuals on
Medicare it is also a more cost effective approach to treating obesity. 1,2,4,7,8 RDNS can
provide intensive behavioral therapy at a lower cost while still providing quality
benefits.8 RDNS services cost 25% less for every 2 ponds of weight loss and an RDNS
fee is 85% less than a primarily care provider fee. 8
Development of a Position
I support the Treat and Reduce Obesity Act 2015. Obesity in the United States is a
problem that is growing rapidly. Providing more treatment options and better accessibly
could aid in the reduction of obese individuals in the United States. Reducing the number
of obese individuals can reduce risk of comorbidities and there for reduce health care
costs overall. I believe that it would be beneficial for individuals that are covered under
Medicare and it would also be beneficial for other health care practitioners such as
registered dietitian nutritionists. This Piece of legislation will increase access to
alternative treatments for obesity and it can lower cost for the patient and the
government. Currently, there are legal barriers to providing intensive behavioral therapy
outside of the primary care setting. Removing this barrier will make it easier for
individuals when trying to reduce weight.
The Treat and Reduce Obesity Act will let other health care practitioners to
provide intensive behavior therapy. According to the Institute of Medicine and US
Preventative Services Task Force agree that RDNS are the most qualified food and
nutrition experts.8 Also it has been found that RDNS giving intensive behavioral therapy
are more likely to help patient lose a significant amount of weight and increase exercise
compared to patient that did not receive intensive behavioral therapy.8 If RDNS were

Rosemarie Biancardi
more assessable this would also reduce cost. It cost less to see an RD compared to a
physician, so Medicare would not have to pay as much for each visit that a patient makes
for weight management. Finally, this piece of legislation promotes the utilization of an
interdisciplinary team approach when treating individuals who are considered obese.
The Treat and Reduce Obesity act also supports the use of weight management
drugs. The use of FDA approved weight management drugs would be covered under
Medicare part D. I believe that weight medications can be effective if taken along with
diet and exercise. There two drugs that have been approved by the FDA BELVIQ and
Qsymia. Although I do not think that medication should be the first line of defense when
helping a patient lose weight, it could be used if diet and exercise alone are not producing
sufficient results. Also Medicare already covers bariatric surgery, so I believe that there
should be other steps that individuals can take to lose weight before undergoing surgery.
Communication of Recommendations to Policymaker
I contacted Senator Dan Coats, Senator Joe Donnelly and Representative Susan
Brooks. I went to the Eat right pro website and log in to my account. After logging in I
went to the action center. Under the action center there is an option to take action for the
Treat and Reduce Obesity Act. When you click to take action there is a letter that has
already been written. The only option available was to send the letter by contact form. I
did not edit the letter; I sent the suggested pre-written letter. I believe that sending this
letter will show that there is interest for this act in the State of Indiana. If Senators and
Representatives do not think that individuals form there state are not interested in a bill/
legislation then they will not be interested in voting for it,so it is important to show
support in any way possible.

Rosemarie Biancardi
Resources
1. Campaign to End Obesity, The Long-Term Returns of Obesity Prevention
Policies, Alex Brill, April 2013. Accessed November 28, 2016.
2. Obesity Action Coalition. Treat and Reduce Obesity Act 2015 Fact Sheet. Obesity
Action Coalition. http://www.obesityaction.org/wp-content/uploads/HR-2404-S1509-TROA-Fact-Sheet.pdf. Accessed November 28, 2016.
3. Ogden, C. L., Carroll, M. D., Kit, B. K., & Flegal, K. M. (2014). Prevalence of
childhood and adult obesity in the United States, 2011-2012. JAMA, 311(8), 806814.
4. Academy of Nutrition and Dietetics. Action center. Treat and Reduce Obesity Act
Sample Legislator Letter. http://www.eatrightpro.org/action%20center. Accessed
November 28, 2016.
5. Obesity Action Coalition. Treat and Reduce Obesity Act 2015 Press Release.
Obesity Action Coalition. http://www.obesityaction.org/newsroom/newsreleases/2015-news-releases/treat-and-reduce-obesity-act-of-2015-re-introduced.
Accessed November 28, 2016.
6. Paulsen E. All Info - H.R.2404 - 114th congress (2015-2016): Treat and reduce
obesity act of 2015. Congress.gov. https://www.congress.gov/bill/114thcongress/house-bill/2404/all-info. Accessed November 28, 2016.
7. Academy of Nutrition and Dietetics. Benefits of the treat and reduce obesity act.
Eatrightpro. http://www.eatrightpro.org/resource/advocacy/disease-preventionand-treatment/obesity-and-weight/benefits-of-the-treat-and-reduce-obesity-act.
Accessed November 28, 2016.
8.

Academy of Nutrition and Dietetics. Key takeaways for the treat and reduce
obesity act. Eatrightpro. http://www.eatrightpro.org/resource/advocacy/diseaseprevention-and-treatment/obesity-and-weight/key-takeaways-for-the-treat-andreduce-obesity-act. Accessed November 28, 2016.