The Biden-Harris administration is dedicating taxpayer dollars to cover weight-loss drugs under Medicare and Medicaid, targeting the obesity epidemic in the U.S.
At a Glance
- Weight-loss drugs like Wegovy and Zepbound may soon be covered by Medicare or Medicaid.
- The proposal could cost up to $35 billion over the next decade.
- The initiative recognizes obesity as a disease treatable with medication.
- Advancements in these medications could reduce cardiovascular deaths by up to 20%.
Proposal Details
The Biden-Harris administration recently unveiled a proposal aimed at addressing the obesity crisis by covering weight-loss drugs under Medicare and Medicaid. The initiative includes medications such as Wegovy and Zepbound, which have gained FDA approval for their effectiveness in significant weight reduction. If enacted, millions stand to benefit, as the rule aims to overturn a law that currently prevents Medicare from covering weight-loss products.
Funding this proposal will be costly, with projections indicating taxpayers could bear up to $35 billion in expenses over the next decade. The expected return on investment in public health could be substantial, however, potentially curbing obesity-related health issues and reducing the nation’s healthcare burden long-term.
The Biden-Harris administration wants to expand coverage of anti-obesity medications in the Medicare and Medicaid programs. https://t.co/L3MKJvc1Aq
— KSL (@KSLcom) November 27, 2024
Beneficiary Details
The initiative focuses on individuals with a body mass index (BMI) of 30 or higher. Such coverage could extend to approximately 3.5 million individuals on Medicare and 4 million on Medicaid. The high cost of these medications, ranging from $1,000 to $1,300 monthly, has made them accessible mainly to wealthier individuals, but this rule aims to level the playing field.
“It’s a good day for anyone who suffers from obesity. It’s a game changer for Americans who can’t afford these drugs otherwise,” U.S. Health and Human Services Secretary Xavier Becerra said.
This rule could significantly decrease out-of-pocket expenses for beneficiaries by as much as 95%. It is part of the administration’s broader effort to reduce prescription drug costs, following legislative moves like the Inflation Reduction Act, which empowers Medicare to negotiate drug prices.
A Biden administration proposal to expand coverage of weight-loss drugs to Medicare and Medicaid recipients is long overdue, @lisamjarvis says https://t.co/gMCwFYI0aU via @opinion
— Bloomberg (@business) November 26, 2024
Response and Future Prospects
Reactions to the proposal vary. Robert F. Kennedy Jr. has voiced opposition, suggesting funding for organic foods and gym memberships as alternative measures. “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 stated.
Others in the pharmaceutical industry disagree, underscoring the potential health benefits of these medications. The proposal is subject to approval and may encounter obstacles from the incoming administration, which aims to cut government expenditure.
