Impact of Statewide Essential Health Benefits on Utilization of Bariatric Surgery

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.