Obesity Drugs to Be Covered by Medicare and Medicaid Under Biden Administration Proposal

Obesity Drugs to Be Covered by Medicare and Medicaid Under Biden Administration Proposal

By Staff Writer | Editorial credit: Marc Bruxelle / shutterstock.com 

In a significant move to address the growing obesity crisis in the United States, the Biden administration has unveiled a proposal that would allow Medicare and Medicaid to cover weight-loss medications. This historic policy change aims to improve access to life-changing treatments for millions of Americans struggling with obesity, a condition that affects over 40% of adults in the U.S.

The proposed plan, which was announced earlier this week, includes coverage for FDA-approved medications such as GLP-1 receptor agonists (semaglutide, liraglutide, and others), which have shown significant promise in helping individuals lose weight and improve related health conditions, including diabetes, hypertension, and heart disease.

Addressing a Public Health Crisis

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Obesity has long been considered a critical public health issue, contributing to a variety of chronic conditions and increasing healthcare costs. The Centers for Disease Control and Prevention (CDC) reports that obesity-related health issues cost the U.S. healthcare system over $170 billion annually. Experts have noted that expanding access to obesity treatments, including medications, could help reduce these costs by preventing or managing conditions such as type 2 diabetes, stroke, and heart disease.

“Obesity is not just a cosmetic issue—it’s a serious health condition that impacts people’s quality of life and leads to costly medical complications,” said Xavier Becerra, Secretary of Health and Human Services. “This proposal reflects our commitment to addressing this growing epidemic and ensuring that all Americans have access to the treatments they need to live healthier lives.”

Expanding Access for Medicare and Medicaid Beneficiaries

Currently, Medicare and Medicaid, two of the most extensive public health programs in the country, do not routinely cover weight-loss medications. While Medicare covers some obesity-related treatments, such as bariatric surgery, prescription medications have largely been excluded. Medicaid coverage varies by state, but many states do not offer coverage for weight-loss drugs, citing cost concerns.

The Biden administration’s proposal would change this by offering coverage for medically necessary weight-loss drugs under Medicare and Medicaid. If approved, the policy change could affect millions of beneficiaries, including seniors, low-income adults, and those with disabilities who are disproportionately impacted by obesity and related health problems.

According to the White House, this policy is expected to benefit around 2 million seniors and low-income individuals who struggle with obesity and meet the criteria for coverage, such as having a body mass index (BMI) over 30 or related comorbidities like type 2 diabetes or heart disease.

A Key Moment in the Fight Against Obesity

The announcement has received widespread praise from public health advocates, and organizations focused on combating obesity. The American Heart Association (AHA) and the Obesity Action Coalition (OAC) hailed the proposal as a critical step in improving access to effective weight-loss treatments.

“We are thrilled by this announcement,” said Dr. Eduardo Sanchez, chief medical officer for prevention at the American Heart Association. “Medications like semaglutide and liraglutide have demonstrated significant success in helping patients achieve sustainable weight loss, and this policy change could be life-changing for so many people who have struggled to find affordable treatment options.”

However, the proposal has faced some opposition from critics who argue that expanding coverage for obesity drugs could increase government spending, which is already under pressure due to rising healthcare costs. Some conservatives have questioned whether such medications should be prioritized in public health programs, especially when there are concerns about long-term effectiveness and side effects.

Looking Ahead

The Biden administration is expected to submit the proposal to Congress in the coming weeks. If approved, it would mark a major shift in U.S. healthcare policy, with implications for millions of people affected by obesity. In addition to expanding access to medications, the administration has called for a comprehensive approach to tackling obesity, including education, prevention, and support services.

As the proposal moves forward, experts hope that this change will help pave the way for a more inclusive healthcare system that addresses obesity as a serious medical condition rather than a matter of personal responsibility and provides the tools needed for Americans to achieve better health outcomes.

This proposal is part of the Biden administration’s broader effort to make healthcare more affordable and accessible. It focuses on addressing long-standing disparities in care for underserved populations.

 

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