Nine years ago, Carla Harrison of Augusta weighed 381 pounds.
“I was brought up with cornbread and to throw a little grease into the food,’’ she said.
Harrison said some family members were also large, and she herself, in addition to being overweight, had high blood pressure and elevated cholesterol and was pre-diabetic.
Then, in 2003, she had gastric bypass surgery, paid for by her health insurance.
“Right away, I started losing weight,’’ Harrison said. “I lost 160 pounds in the first year.’’
In all, she lost about 200 pounds. Now 52, she exercises regularly, eats healthier and has quit smoking. “I feel fabulous,’’ she said. “My heart is great.’’
Harrison came to the state Capitol on Wednesday to testify to lawmakers about the state’s removal of bariatric surgery as a covered benefit in the state employees’ health plan.
In other health care activity at the General Assembly, a bill that would require drug tests for applicants for welfare and Medicaid benefits passed a Senate subcommittee. And a proposal to require schools to train personnel to help students manage their diabetes passed the House Health and Human Services Committee.
Eliminating the bariatric surgery benefit was just one way state officials are seeking to reduce the massive shortfall in the State Health Benefit Plan (SHBP), which covers almost 700,000 state employees, teachers, retirees, school workers, and dependents.
SHBP had faced a combined projected deficit of $815 million for this fiscal year and fiscal 2013 before taking steps to reduce that shortfall.
Cited as causes for the deficit were rising medical costs; fewer young, healthy workers paying into the system; and the fact that the previous governor, Sonny Perdue, and state lawmakers used SHBP reserve funds to bolster past state budgets.
To stabilize the health plan’s finances, the Department of Community Health raised insurance premiums by 11 percent and 17 percent for employees; hiked co-pays for certain prescription drugs; created a wellness option for members; and increased school districts’ costs to cover non-certificate personnel.
Community Health officials project that eliminating bariatric surgery coverage will save $1.75 million in fiscal 2012 and $3.5 million next year.
The cost of the surgery, which can include gastric bypass, is roughly $15,000 to $22,000.
A surprising testimonial
The prospect of eliminating that coverage, though, has created some concern among legislators.
Bariatric surgery is done for people who are severely obese, Joseph Nadglowski, president of the Obesity Action Coalition, told the House health committee. It pays for itself within four years from savings on patients’ health care bills, he said. “Their health conditions go away’’ after the procedure, he said.
Dr. Titus Duncan, a surgeon at Atlanta Medical Center, told Georgia Health News before the hearing that more than 3 of 4 bariatric surgery patients have permanent weight loss, less sleep apnea and lower cholesterol, and even see their Type 2 diabetes dissipate.
About 75 percent of employers with 20,000 workers or more cover these procedures, but that number drops to 46 percent for firms with fewer than 1,000 workers, according to a 2011 survey by human resources consulting firm Mercer.
The number of people getting this weight-loss surgery has skyrocketed in the past decade.
A member of the health committee, Rep. Sheila Jones (D-Atlanta) told the hearing that she had bariatric surgery herself, in 2004. “I found it very helpful,’’ she said. “It’s a great procedure.’’
Advocates for the benefit would like the Legislature to adjust the budget to restore funding for the surgery.
Earlier Wednesday, a Senate Health and Human Services subcommittee approved Senate Bill 292, which would require drug testing of public benefit applicants.
The legislation, sponsored by Sen. John Albers (R-Roswell), aims to ensure that government funds are used ‘‘for the intended purpose of alleviating the effects of poverty and are not diverted to illicit drug use.’’
“Our dependency on entitlement programs has grown at an alarming and unsustainable rate. It is time for an era of responsibility and accountability,” Albers told Roswell Patch last year in pre-filing the bill.
A similar proposal has been introduced in the Georgia House.
Justice or stereotyping?
The Georgia Council on Substance Abuse is among several organizations opposing the drug-testing legislation.
Neil Kaltenecker, executive director of the council, said in a statement that drug testing is expensive. She said many states have rejected random tests because they found they were not worth the cost.
She cited statistics indicating the difference in the percentages of welfare and non-welfare recipients who use illegal drugs is insignificant. The drug tests are also probably unconstitutional, Kaltenecker added.
In October, a federal judge temporarily blocked Florida’s new law requiring welfare applicants to pass a drug test before receiving benefits, saying it may violate the U.S. Constitution’s ban on unreasonable searches and seizures.
Albers, though, said the federal welfare reform act passed in the 1990s allows for such drug testing. He told Roswell Patch, “We are working with the attorney general’s office here in Georgia and Florida. We all believe the law will support drug testing.”
The Senate bill would make the applicant ineligible for one month after testing positive for drugs. For a second positive test, the person would be ineligible for three months.
More than two dozen states have proposed drug testing of recipients of welfare or other government assistance, according to a Huffington Post article.
Kaltenecker said such drug testing stigmatizes addicts and ‘‘takes a punitive approach to a public health issue.’’
Child’s illness creates an advocate
Also Wednesday, the House health committee approved a bill that would require schools that have a student with diabetes to train two workers in how to help such children.
House Bill 879’s sponsor, Rep. Matt Ramsey (R-Peachtree City), testified that his daughter, 8, was diagnosed with Type 1 diabetes last year.
“There are thousands of parents all over this state who are dealing with this with their children,’’ he said.
Ramsey said that under the legislation, school workers would be trained in basic diabetes information –- ‘‘to help a child navigate this disease and recognize the emergency signs.’’ Many schools in Georgia don’t have nurses, he noted.
Dozens of states have laws similar to the one he’s sponsoring, Ramsey said.
The American Diabetes Association also testified in support of the diabetes legislation.