Biden Proposes Expanding Weight-Loss Drug Coverage to Medicare and Medicaid

On Tuesday, November 26th, the Biden administration proposed requiring Medicare and Medicaid to cover anti-obesity medications such as Ozempic and Wegovy. This initiative aims to address America’s growing obesity epidemic, which affects over 40% of the population. Currently, these drugs are covered only for conditions related to obesity, like diabetes and heart disease. The proposed change would expand coverage to millions of low-income and elderly Americans who rely on these programs.

If implemented, the proposal would make these medications affordable to approximately 3.4 million Medicare recipients and 4 million Medicaid enrollees. By classifying obesity as a chronic disease, the plan aims to reduce health disparities, as cost often prevents access to these treatments. Drugs like Wegovy, which mimic appetite-regulating hormones, currently cost over $1,000 monthly, putting them out of reach for many Americans.

The initiative, while transformative, is expected to spark debate. Federal spending for Medicare and Medicaid could increase by $36 billion over the next decade, prompting criticism from fiscal conservatives. Some experts, however, argue that improved access to these medications could reduce long-term health costs by preventing conditions like heart disease, diabetes, and sleep apnea.

The proposal also faces uncertainty with the incoming administration of President-elect Donald Trump. Key health appointments, including Robert F. Kennedy Jr. as Secretary of Health and Human Services, have expressed skepticism toward these drugs. Kennedy has criticized their high costs and suggested alternative solutions, such as improving nutrition and fitness programs. However, CMS nominee Mehmet Oz has publicly supported medications like Ozempic for weight management.

Advocates highlight the need for equitable access to these treatments, particularly for at-risk groups. Studies have shown racial disparities in prescriptions for anti-obesity drugs, with white patients receiving the majority. Expanded coverage under Medicare and Medicaid could address these inequities, according to public health officials.

This proposal marks a significant step in redefining obesity as a public health priority. While the final decision rests with the next administration, the debate underscores the complexity of balancing public health needs with fiscal responsibility. The proposal’s outcome could reshape healthcare access for millions of Americans.