Impact of Statewide Essential Health Benefits on Utilization of Bariatric Surgery

Abstract

Background: In response to concerns about inadequate insurance coverage, bariatric surgery was included in the Affordable Care Act’s essential health benefits program—requiring individual and small-group insurance plans in 23 states to cover bariatric surgery. We evaluated the impact of this policy on bariatric surgery utilization. Methods: Multiple-group interrupted time series analyses of IBM MarketScan commercial claims data from 2009 to 2016. Results: Bariatric surgery utilization increased in all states after ACA implementation, but this increase was no greater in states with a bariatric surgery essential health benefit. Conclusions: Our findings suggest that the essential health benefits program may have been too narrow in scope to meaningfully increase bariatric surgery utilization at the population level.