The Biden administration proposed a new rule Tuesday that would allow anti-obesity drugs like Wegovy and Zepbound to be covered under Medicaid and Medicare for more Americans.
Millions of Americans are diagnosed with obesity, which is considered a chronic disease that can lead to serious health consequences like cardiovascular disease, stroke and diabetes. One recent study found three-quarters of U.S. adults are overweight or obese.
Medicare and Medicaid currently cover the cost of some obesity medication to treat certain conditions like diabetes and heart disease. The proposed rule would increase access to the drugs for roughly 3.4 million Medicare users and about 4 million Medicaid enrollees, according to a White House press release.
Under the rule, older and/or low-income Americans with a body mass index of 30 or higher would qualify for coverage for the drugs.
“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,” according to the press release.
The cost of rolling out such an expansion in coverage would be significant, and a bill authorizing Medicare to cover anti-obesity medication has been stalled in Congress for years.
Expanding Medicare access to these drugs would cost the federal government about $35 billion over the next decade, according to an estimate released last month by the Congressional Budget Office.
The fate of the proposed rule ultimately lies in the hands of the incoming Trump administration, and it is unclear what will happen given the differing views on the drugs among some of President-elect Trump’s Cabinet picks.
Trump’s pick for secretary of the Department of Health and Human Services, Robert F. Kennedy Jr., has publicly spoken out against anti-obesity medications. Meanwhile, Trump’s pick to run the Centers for Medicare and Medicaid Services, Mehmet Oz, has spoken positively about the drugs in the past.
