Obesity Drugs Would Be Covered by Medicare and Medicaid Under Biden Proposal

In one of its last major policy directives, the Biden administration proposed on Tuesday Medicare and Medicaid cover obesity drugs, an expensive and likely popular policy that would need support from the Trump administration to become official.

The proposal would expand access to the drug to millions of Americans currently uninsured.

New obesity drugs such as Novo Nordisk’s Wegoby and Eli Lilly’s Zepbound have been shown to improve health in a variety of ways, but legislation passed 20 years ago allows Medicare to “weight-loss” drugs. Can’t cover drugs for.

The new proposal circumvents that restriction and specifies that drugs aimed at treating the disease obesity and preventing related symptoms would be covered.

“We don’t want to see people having to wait until they have these new illnesses before they can get treatment,” said Chiquita Brooks LaSure, administrator of the Centers for Medicare and Medicaid Services (CMS). He pointed out that there is a growing medical consensus that Obesity is a chronic health condition.

This classification also means that starting in 2026, all state Medicaid programs will be required to cover this drug. Currently, only a handful are applying it.

CMS estimates that approximately 3.4 million more patients in Medicare will become eligible for obesity drugs and approximately 4 million more patients in Medicaid will receive coverage, costing the program billions of dollars. There is. Medicare primarily covers Americans age 65 and older. Medicaid primarily targets poor Americans and Americans with disabilities.