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Medicaid & SCHIP; Obesity


In a widely publicized decision issued in 2004, the United States Department of Health and Human Services removed language from the Medicare Coverage Issues Manual which stated that obesity is not an illness, a pronouncement that paves the way for Medicare coverage of evidence-based obesity treatments. This determination by HHS also has important implications for public and private insurance coverage of health care services and interventions that have the potential to reduce the risk of lifelong obesity in children.

This Report assesses the implications of the 2004 HHS obesity ruling into the context of public and private health insurance for children. It begins with an overview of what is known about obesity risk in childhood, as well as its short-term and long-term health consequences and then reviews the evidence of effective health interventions for children at risk. The Report then considers the implications of the 2004 decision for private health insurance coverage for children, followed by a more extended discussion of its implications for children covered under Medicaid and the State Children's Health Insurance Program (SCHIP). The Report concludes with a discussion of strategies for engaging both public and private insurers in a systematic effort to increase investment in preventive health services for children at risk of obesity.

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