Maine Woman Sues Cigna Over Obesity Drug Coverage

TL;DR

Jamie Whittemore has filed a class action lawsuit against Cigna for denying coverage of obesity drugs, claiming violation of the Affordable Care Act's anti-discrimination provisions. This case could set a precedent for insurance coverage of obesity treatments.

In a groundbreaking legal move, Jamie Whittemore from Maine has initiated a class action lawsuit against the insurance giant Cigna. The lawsuit accuses Cigna of violating the Affordable Care Act by not covering medications prescribed for obesity treatment, which is recognized as a disability.

Details of the Lawsuit

Jamie Whittemore's lawsuit, filed in U.S. District Court in Portland, asserts that Cigna's refusal to cover obesity drugs like Zepbound and Ozempic constitutes discrimination based on disability. These drugs, while often covered for diabetes, are frequently denied for weight loss purposes despite their effectiveness. Whittemore, who has struggled with obesity, highlighted the significant personal impact of Cigna's policy, which has left her without affordable treatment options[1].

Legal and Healthcare Implications

This lawsuit could potentially affect the broader health insurance market by setting a precedent for how obesity is treated under the Affordable Care Act. Legal experts argue that denying coverage for obesity drugs is a form of disability discrimination. The outcome of this case could compel insurers to revise their coverage policies regarding weight loss medications, impacting many patients nationwide who face similar coverage denials[1].

Cigna's Response and Industry Trends

As of the latest updates, Cigna has not provided a public response to the lawsuit. However, the company had previously announced a program to cap cost increases for new weight-loss drugs at 15% annually, indicating a recognition of the growing demand and cost concerns related to these treatments. This lawsuit places additional pressure on Cigna and potentially other insurers to make obesity treatments more accessible and affordable[1].

Jamie Whittemore's lawsuit against Cigna marks a significant challenge to the way obesity is treated by health insurers under the Affordable Care Act. The outcome of this case could have wide-reaching implications for the insurance industry and for individuals struggling with obesity across the United States.

Notable Quotes

"Cigna's exclusion of medications to treat obesity is discrimination, plain and simple." - Eleanor Hamburger

"So the basis of our suit is that our client has been discriminated against on the basis of disability by the denial of the insurer to provide coverage for obesity." - Jeffrey Young

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