The Biden administration has proposed a rule to extend Medicare and Medicaid coverage to include costly anti-obesity medications such as Wegovy and Ozempic, potentially benefiting millions of Americans struggling with weight loss. This move could reduce out-of-pocket costs by up to 95%, addressing the high costs of these drugs, which can reach $1,000 a month without insurance
Current Medicare coverage is limited to patients with diabetes or cardiovascular issues, but the new rule would allow an estimated 3.4 million Medicare recipients and 4 million Medicaid enrollees with obesity to access these treatments. The initiative addresses the rising obesity rates, which affect over 40% of Americans, and seeks to alleviate health risks associated with obesity, such as heart disease and diabetes.
“Today’s new proposal would expand access to these innovative medications for obesity, which is widely recognized as a disease and help an estimated 3.4 million Americans with Medicare. Medicare coverage would reduce out-of-pocket costs for these prescription drugs by as much as 95 percent for some enrollees,” the White House said in a statement Tuesday. “Approximately 4 million adult Medicaid enrollees would also gain new access to these medications. This proposal would allow Americans and their doctors to determine the best path forward so they can lead healthier lives, without worrying about their ability to cover these drugs out-of-pocket, and ultimately reduce health care costs to our nation.”
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The measure has been lauded as a significant step in public health by health experts and officials, including HHS Secretary Xavier Becerra, who emphasized its potential to improve national health and economic outcomes.
“It’s a good day for anyone who suffers from obesity,” HHS Secretary Xavier Becerra told The Associated Press. “It’s a game changer for Americans who can’t afford these drugs otherwise.”
The estimated cost of the proposal could reach $35 billion over the next decade, raising concerns about its financial implications. It remains unclear whether the proposal will be finalized before President Biden leaves office in January, leaving incoming President Donald Trump to influence the final decision.
Despite support from many lawmakers, the proposal faces potential opposition from the pharmaceutical industry and Robert F. Kennedy Jr., who may challenge the measure if appointed Health and Human Services Secretary under the second Trump administration.
“For half the price of Ozempic, we could purchase regeneratively raised, organic food for every American, three meals a day and a gym membership, for every obese American,” Kennedy said to a group of federal lawmakers during a roundtable earlier this year.
Connor Walcott is the lead writer for Valuetainment.com. Follow Connor on X and look for him on VT’s “The Unusual Suspects.”
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