Question:
Any thoughts on how last week's ruling will affect the insurance co's.

I was out of the country last week when the Supreme Court ruled that "correctable" disabilities aren't covered under the ADA. Do you feel that insurance co's will now use this to weasel out of paying for surgery, since WLS "corrects" morbid obesity; therefore the condition won't be covered? My consult was rescheduled so I'm getting nervous.    — Joyce L. (posted on June 28, 1999)


June 28, 1999
Joyce, Let me try to explain what the Supreme Court was talking about. What they are saying is that if something is correctable with medication, glasses, anything that brings you back to "normal", then you are not considered disabled. OK, so its like this ... if you are near sighted and can wear glasses to bring you up to normal vision, you cannot park in a handicap parking space. If you have high blood pressure and can take a pill to keep it in range, and it fixes you, you are NOT disabled. This in no way means that if something will fix you the insurance company does not have to pay it. They still have to give you the glasses to fix your sight, they still have to cover high blood pressure ... and I cannot imagine how it would ever impact WLS. Good luck, and have fun Mary Anne
   — Mary Anne M.

June 28, 1999
Most insurance doesn't cover morbid obesity now. What they do cover is the permanent treatment of the co-morbidies related to it. So I would hope that it won't have a large impact on WLS.
   — dboat

June 28, 1999
Unless your insurance coverage specifically excludes surgical treatment for morbid obesity, they MUST cover it!!! Medical insurance isn't for covering only people who qualify under the American Disabilities Act. So I don't think that this would apply at all to insurance, except maybe if someone were trying to get financial payment under a disability policy. However what I DO see this as ... is a way for employers, and others to openly and blatently discriminate against morbidly obese people without any protection for us to site as reason for them not to. Being covered under the guidelines of the ADA protects us from losing a job for being "fat" and such things as that. It doesn't provide for coverage to be granted or denied under a Health Insurance Policy. I think it's apples and oranges ... two totally different issues.
   — Sherrie G.

June 29, 1999
Actually the ADA does cover health insurance, and prevents the employer/insurer from using disability based distinctions. A policy cannot contain exclusions or other terms that discriminate against the disabled. That's why mentally ill patients have seen some limited success in eliminating differing limits for physical and mental disabilities. Attorneys have had some success in reversing refusals of coverage for WLS by referring to the disability based distinctions clause of the ADA; however the courts in general are very discriminatory against morbid obesity as being a covered disability. The ruling does appear to have a loophole in how it applies to health insurance which would only be fixed by strengthening the ADA to prevent discrimination against morbid obesity (best for us in the long run) or until another case makes it to the Supreme Court and decides the issue in greater detail. This ruling was extremely damaging in many ways to the disabled and strips a great deal of the protection that was fought for and won.
   — Joyce L.




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