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Health Aff (Millwood). 2015 Nov;34(11):1923-31. doi: 10.1377/hlthaff.2015.0633.

Severe Obesity In Adults Cost State Medicaid Programs Nearly $8 Billion In 2013.

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Y. Claire Wang ( is an associate professor in the Department of Health Policy and Management at the Mailman School of Public Health, Columbia University, in New York City.
John Pamplin is a graduate student research assistant in the Department of Epidemiology, Mailman School of Public Health, Columbia University.
Michael W. Long is an assistant professor at the Milken Institute School of Public Health, the George Washington University, in Washington, D.C.
Zachary J. Ward is a programmer analyst in the Harvard T.H. Chan School of Public Health, in Boston, Massachusetts.
Steven L. Gortmaker is a professor in the Department of Social and Behavioral Sciences at the Harvard T.H. Chan School of Public Health.
Tatiana Andreyeva is an associate professor in the Department of Agricultural and Resource Economics and director of economic initiatives at the Rudd Center for Food Policy and Obesity, University of Connecticut, in Hartford.


Efforts to expand Medicaid while controlling spending must be informed by a deeper understanding of the extent to which the high medical costs associated with severe obesity (having a body mass index of [Formula: see text] or higher) determine spending at the state level. Our analysis of population-representative data indicates that in 2013, severe obesity cost the nation approximately $69 billion, which accounted for 60 percent of total obesity-related costs. Approximately 11 percent of the cost of severe obesity was paid for by Medicaid, 30 percent by Medicare and other federal health programs, 27 percent by private health plans, and 30 percent out of pocket. Overall, severe obesity cost state Medicaid programs almost $8 billion a year, ranging from $5 million in Wyoming to $1.3 billion in California. These costs are likely to increase following Medicaid expansion and enhanced coverage of weight loss therapies in the form of nutrition consultation, drug therapy, and bariatric surgery. Ensuring and expanding Medicaid-eligible populations' access to cost-effective treatment for severe obesity should be part of each state's strategy to mitigate rising obesity-related health care costs.


Epidemiology; Health Promotion/Disease Prevention; Medicaid; Public Health

[Indexed for MEDLINE]

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