Human Services Committee
JOINT FAVORABLE REPORT
Bill No.: SB-282
AN ACT CONCERNING MEDICAL ASSISTANCE FOR BARIATRIC SURGERY
Title: AND PRESCRIPTION DRUG TREATMENT OF OBESITY.
Vote Date: 3/17/2022
Vote Action: Joint Favorable Substitute
PH Date: 3/10/2022
File No.:
Disclaimer: The following JOINT FAVORABLE Report is prepared for the benefit of the
members of the General Assembly, solely for purposes of information, summarization and
explanation and does not represent the intent of the General Assembly or either chamber
thereof for any purpose.
SPONSORS OF BILL:
Human Services Committee
REASONS FOR BILL:
S.B. 282 will require the Commissioner of Social Services to provide medical assistance for
bariatric surgery and prescription drug treatment of obesity. This bill will essentially recognize
obesity as a disease and ensure that vulnerable populations of our state can receive the
medical care they need to live comfortable and fulfilled lives. This bill will provide financial
coverage to those who could otherwise not afford treatment, promoting equity in care.
SUBSTITUTE LANGUAGE:
The substitute language defines "body mass index", "severe obesity", and "medically
necessary". These serve to clarify what these terms mean in context to the bill, and how they
can be measured and calculated to determine eligibility for financial coverage for surgery or
medication. The substitute language also changes the dates to be more realistic to require by
April 1, 2023 that the Commissioner of Social Services can provide reimbursement.
RESPONSE FROM ADMINISTRATION/AGENCY:
Commissioner of the Department of Social Services, Deidre Gifford, supports the intent
of Committee Bill No. 282 with recommended substitute language to enable the department
to have the flexibility to implement the policy change efficiently and have sufficient time to
make the changes necessary. DSS also caution that further research may expose the need
for additional appropriations to implement the change as there is no funding in the Governor's
recommended budget adjustments to financially support it.
NATURE AND SOURCES OF SUPPORT:
Senator of the Connecticut General Assembly, Eric Berthel, supports the bill because as
a recipient of bariatric and metabolic surgery, he attests that it is an effective and lifesaving
procedure. Improving the quality of life via proven medicine should be a priority, and the
financial data demonstrates that investing in metabolic and bariatric surgeries reduce the cost
for future healthcare expenses because these surgeries eliminate many of the co-morbidities
associated with obesity.
Representative of the Connecticut General Assembly, Travis Simms, supports this bill
and believes that it will attempt to change current health care stigmas as it relates to obesity
and will give everyone access to a better quality of life. Obesity is a health crisis that is
prevalent our nation and state, and bariatric and metabolic surgery has a proven track record
of improving many conditions that are associated with an individual being overweight. This bill
is very near and dear to him as he has lost 3 siblings over the past 4 years because of
genetic related obesity diseases. Moving this bill forward will help save the precious lives of
Connecticut residents.
Representative of the Connecticut General Assembly, William A. Petit, Jr, supports this
bill. As a former practicing endocrinologist, he referred many people with diabetes,
hypertension, dyslipidemia, and other associated metabolic disorders for bariatric procedures
after counseling, education, nutritional support, medications, and exercise failed to achieve
significant goals. Obesity and its accompanying metabolic/disease states contribute to
significant loss of life years, diminished quality of life, and significantly decreased productivity.
He argues that the past two decades have shown that various bariatric procedures produce
excellent results in appropriately screened patients. It increases the life span of those who
receive them, allow patients to return to the workforce and be productive members of society
and, perhaps most importantly, allow them a dramatically better quality of life personally and
in their roles as family members and friends.
Melissa Mitri, President, Connecticut Academy of Nutrition and Dietetic, supports S.B.
282 because it will enable coverage for obesity treatment for the most vulnerable populations
- HUSKY B and Medicaid beneficiaries. This bill would provide coverage for prescription drug
medications to treat obesity in those who qualify with a body mass index (BMI) greater than
thirty-five. For them, medical nutrition therapy is an effective disease management strategy
that reduces risk of chronic disease, promotes healthy weight loss, slows disease
progression, and reduces symptoms and is cost-effective. They think it is a critical step to
increase access to essential obesity treatments for the most vulnerable populations in
Connecticut.
Sara D Moore, APRN, Moore Wellness Solutions, supports the bill. Obesity is a chronic
illness associated with many related diseases, such as dyslipidemia, hypertension, diabetes,
and some cancers. Having access to these medications being covered by insurance will not
only be life-changing for patients who suffer from obesity, but also well benefit our
overstretched healthcare system that is burdened by the sequela of chronic disease.
Maribel Nieves of Stratford, CT supports the bill indicating countless reasons why this
surgery changed her life. She is advocating for people like her that desperately need the help
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of bariatric surgery that are being denied. She is urging the legislation to consider passing the
bill that will help end this epidemic of obesity.
Dr. Stephanie Ortiz Page, Medical Director Metabolic Medical Weight Loss Program
Nuvance Health, supports the bill. She argues that increasing access and coverage to
include Bariatric Surgery and anti-obesity medications for these patients will not only improve
the quality of lives of many patients, but it will also greatly diminish the health care cost
burden that the complications of obesity lead to nationally and specifically to the state of
Connecticut which is at approximately 21.5 billion dollars.
Pavlos Papasavas, Past President, CT Chapter of ASMBS, Associate Clinical Professor
of Surgery, University of Connecticut Director of Surgical Research, Hartford Hospital,
supports the bill. According to him, he has dedicated his surgical career to the treatment of
Obesity, a chronic and debilitating disease that affects 27% of the population in Connecticut.
In Connecticut, obesity disproportionally affects minorities: 37.1% African Americans, 31.8%
Hispanics versus 24.4% Caucasians. The age group most affected by obesity is 45-64
(30.8%). 13.4% of our children, ages 10-17, suffer from obesity. Obesity costs our state more
than $20 billion per year. He argues that bariatric and metabolic surgery is currently not
considered an essential health benefit in Connecticut. It is a covered benefit in New York,
Massachusetts, Rhode Island, Vermont, Maine, and New Hampshire. CT is the only state in
New England with Affordable Care Act plans that do not cover bariatric surgery. It is time to
rectify this injustice. For him, treatment for cancer, heart disease, kidney disease, or any
other serious health problem would never be denied, and there should not be limited access
to obesity treatments.
Stamford Health, Kathleen Silard, supports the bill. Stamford Health supports public
policies that provide tools to live a healthier life including access to services that can help
residents achieve and maintain a healthy weight. Obesity is a condition that underlies a wide
range of deadly and pernicious diseases such as diabetes, stroke, hypertension, and
cardiovascular disease. Obesity is also linked to certain types of cancer.
Leslie Sinclair of Avon, CT, supports the bill because her and her husband paid for her
surgery out of pocket, and it put a huge financial burden on us and a psychological burden on
myself. She argues that nobody should be denied coverage for this life saving surgery. Being
obese can causes heart disease, cancer, high blood pressure, pulmonary embolisms, DVT
blood clots, depression and anxiety, Joint deterioration, respiratory issues. Insurance
Companies and small businesses that offer health care benefits, need to provide this
coverage.
Larke Spaulding supports the bill. Husky paid for her first 8 weeks of treatment then
declined as they do not consider weight loss drugs necessary. The average retail price for a
4-week supply of Wegovy is approximately $1400 and she doesn't know how many people
can afford that on their own. It would be exceptionally beneficial to have renewed and
continued coverage of this drug, even if that benefit came with a co-pay. Any coverage would
be better than none when dealing with a drug that literally changes the health and life of its
users.
Louis Telesford, MD Hamden Medical Group, supports the bill. He argues that despite the
cost of these approved medications, Saxenda and Wegovy, the degree of weight loss
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accomplished will have long term savings by virtue of its positive impact on chronic medical
diseases. These include but are not limited to morbid obesity, sleep apnea, hypertension,
cardiovascular disease, and the prevention of diabetes and its complications.
Liz W. of Bridgeport, CT, supports the bill, citing her experience in 2015. She was fortunate
enough to receive a life-changing gastric sleeve surgery from Dr. Neil Floch of Fairfield
County Bariatrics. The ease of the surgery and what it did for he compared with a lifetime of
battling and failing to be able to manage a health condition of chronic insulin resistance and
obesity is without question the most important thing she has done for herself. She argues that
both surgery and effective medications being covered by insurance is critical to our nations
health and that it is life changing, effective, and real-life help.
According to all the following people, obesity can affect all age groups, races, and
demographics, but significantly and disproportionately affects lower socioeconomic classes
and persons of color. Obesity worsens quality of life and shortens life expectancy, causing
many health conditions including but not limited to cancer, diabetes, high blood pressure, and
even early death by stroke, heart attack, and blood clots.
These advocates of the bill claim that healthcare costs for those with obesity are notably
higher when compared to those without obesity. Passing this bill will remove a major obstacle
for patients to meet the requirements to be considered for bariatric surgery. Obesity is not
different from other diseases that are acknowledged by the state.
All the following individuals support this bill reasoning that metabolic and bariatric surgery is
the only substantial proven weight loss method that can resolve, improve, or put these
conditions into remission:
Cynthia Joiner of Manchester, CT Madhuvanti Joshi, Bariatric Physician Assistant
Abigail Klein of Enfield, CT Nuvance Health and Danbury, New Milford, Norwalk, and
Sharon hospitals
Alexis Loss of Woodbridge, CT Melanie Maloney of Enfield, CT
Christopher M. Mann of Suffield, CT John A. Mann of Vernon, CT
Nicole Yopp of Middletown, CT Michelle Martins of Wethersfield, CT
Meagan Moskowitz of Simsbury, CT Bethany Mulone of Guilford, CT
James T. Murphy of West Suffield Cassandra Neal, Hartford Healthcare Medical Group,
Glastonbury Surgical Weight
Jonathan Aranow, Past President Connecticut Chapters of Brianna Ba, PharmD
the American Society for Metabolic and Bariatric Surgery
Valerie Becker, Weight Management Dietitian at Haley Duscha, Weight Management Dietitian at Connecticut
Connecticut Children's Medical Center Children's Medical Center
Carmel Bowron of Stratford, CT Sasha Brown, Call Center Representative of Hartford
Healthcare Medical Group
Yvonne Candelario-Morgan of East Hartford, CT Dana Cantiello, Bariatric Surgery/Obesity Medicine Nurse
Practitioner
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 Kristen Chapin, Physician's Assistant of East Granby, CT Amy Corcoran, Student Liaison Co-Chair
Nilda Cyphers of Meriden, CT DeBrandson Davidson
Margaret Dolan of Norwalk, CT Michelle Donewald of Wallingford, CT
Cheryl Dostie of New Britain, CT Katy Dunay of Redding, Connecticut
Johanna Eichner, Connecticut Academy of Nutrition and Christine Finck, Surgeon-in-Chief at Connecticut Children's
Dietetics Medical Center
Kevin Fitzpatrick Kathleen Flaherty, Executive Director of CT Legal Rights
Project, Inc.
Neil Floch, Immediate Past President of the American Aimee Fucci, General, Metabolic and Bariatric Surgeon
Society of Bariatric and Metabolic Surgeons
Christopher Gallagher, Federal and State Affairs Consultant Lynn Gallnot of Manchester, CT
for the Obesity Action Coalition
Dawn Garcia of Hebron, CT Saber Ghiassi, Faculty of the Yale School of Medicine
Carolyn Haight of Milford, CT Linda Halpin of Bloomfield, CT
Andrea Hart of Madison, CT Jill Helton of Plantsville, CT
Anita M. Howard of Hamden, CT Joshua I Hrabosky. Psychiatry and Behavioral Health at
Greenwich Hospital
Christopher Lehrach, Nuvance Health Chief Medical Officer Lisa Perry of Winsted, CT
Amy Ralph of Milford, CT Matthew Ryan Strouse, Employee of Yale New Haven
Hospital
Franchesca Rivera of Wethersfield, CT Sonia Rivera, Medical Assistant Hartford HealthCare
Medical Group General, Metabolic and Bariatric Surgery
Taslima Shaikh, MD Diplomate, American Board of Obesity Matthew Stults-Kolehmainen, Digestive Health
Medicine Board certified, ABFM Medical Weight Multispecialty Clinic Yale New Haven Hospital
Management, Department of Bariatric Surgery Hartford
Healthcare Medical Group
Jane Sweeney, Clinical Manager, Bariatric Surgery and Darren S. Tishler, President, Connecticut Chapter American
Obesity Medicine Practice Society for Metabolic and Bariatric Surgery Chief, Metabolic
and Bariatric Surgery, Hartford HealthCare
Devika Umashanker of Glastonbury, CT
NATURE AND SOURCES OF OPPOSITION:
No additional concerns or opposition expressed.
Reported by: Isaac Agyemang-Duah & Molly Date: 3/24/22
Lukiwsky
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