Bad news for Medicare and Medicaid beneficiaries: These drugs will not be covered by the programs
The Trump administration has decided against expanding coverage to allow certain drugs to be used for weight loss in the case of those who are obese.
The Biden administration had proposed to reinterpret a statute that doesn’t let Medicare and Medicaid cover weight-loss drugs when used specifically for that purpose and allow them to be used to treat obesity. However, the Centers for Medicare and Medicaid Services (CMS) tasked with the review has announced that the proposal is “not appropriate at this time.”
Although CMS spokesperson Catherine Howden did say that “pending further review of both the potential benefits of these drugs” the agency “may consider future policy options” for anti-obesity medications (AOMs). The blockbuster drugs like Ozempic and Mounjaro are still covered under Medicare when prescribed to treat other disorders like diabetes and heart disease.
Expanding coverage of weight-loss drugs would be costly
Expanding Medicare and Medicaid coverage to the class of weight loss drugs known as GLP-1s would have given over 7 million people access to them. The change would have been costly, increasing expenses by $25 billion for Medicare and $15 billion for Medicaid over 10 years according to CMS estimates.
Make America Healthy Again says obesity can be treated in other ways
Health and Human Services Secretary Robert F. Kennedy Jr and his advisors have been critical of them and say that using GPL-1 drugs for weight loss goes against the principles of the Make American Healthy Again movement. They argue that the obesity problem in the United States can be solved with improved diets and more exercise.
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