Medicaid Obesity Burden — Model Comparison

The question a planner actually asks: "why is your number different from the published models, and which should I trust?" This puts our Medicaid-eligible estimate next to the two free state-level projections — Harvard CHOICES (low-income and general-population) and IHME/GBD — and explains, per state, exactly why they diverge. Phase 3 of the projection engine.

All series use obesity, BMI ≥ 30 (not overweight+obesity), adults. Compared at 2030 (CHOICES horizon); IHME is a longer-horizon general-population benchmark.

Our Medicaid-eligible estimate (re-based) CHOICES low-income (their Medicaid proxy) CHOICES overall (general pop)

Side-by-side — projected adult obesity rate

Model / seriesPopulation20262030HorizonBase data

Grounded in real numbers (Phase 4)

Denominator = total Medicaid/CHIP enrollment (KFF State Health Facts, ~2024) × an assumed 45% adult-19–64 share (national approximation). Replace with your plan's covered lives for a real read — that swap is the paid engagement.

Why they differ —

None of the three models the post-2023 GLP-1 trend break. All four lines are "no-intervention" trajectories — read them as the baseline a GLP-1 program would bend, not as forecasts that already include it.
Method, sources & honest caveats

Our estimate (re-based). We anchor a current Medicaid-eligible obesity rate and borrow CHOICES's validated low-income slope: projected(yr) = CHOICES_blend(yr) × (anchor ÷ CHOICES_blend(2026)). New Jersey's anchor is our independent v1.5 calibration (~40%); other states default to the CHOICES-implied 2026 level until you plug in a measured rate.

CHOICES low-income. Average of CHOICES's <$20k and $20k–$50k obesity bands — the Medicaid-eligible income range straddles the $20k line, so a blend beats the poorest band alone. CHOICES overall is its all-income state figure (general population).

IHME. Shown as a cited general-population benchmark only — its data license is non-commercial and bars derivative works, so its figures are referenced, never ingested. Published national adult obesity is forecast to reach ~57% by 2050 (men 55.3% / women 58.8%); Southern states (incl. Mississippi) stay highest, and Colorado is flagged for unusually rapid adult increase.

Honesty guardrail. Eligibility is computed (an FPL/MAGI rule), the burden is a calibrated extrapolation, and a true enrollee-level predictive model needs claims (the paid path). Public data is a proxy; the exact number needs the plan's own data.

Sources: CHOICES / Ward ZJ et al., NEJM 2019;381:2440-50 (per-state income tables, choicesproject.org). IHME / GBD 2021, Lancet 2024 (state + national obesity to 2050). KFF State Health Facts — total Medicaid/CHIP enrollment (~2024) and GLP-1 obesity coverage (Jan 2026). Demo set: 7 states; extensible to 51 via the same CHOICES scrape.

Phase 3–4 of the Obesity Burden Navigator eligibility + projection engine. Calibrated comparison — not a prediction, not legal/clinical advice. IHME shown as a cited benchmark, not ingested.