Health Leaders Applaud Biden’s Proposal to Expand Medicare/Medicaid Coverage for Anti-Obesity Medicine

Several health care leaders are showing support for the new proposed law of the Biden-Harris Administration that would extend GLP-1 coverage to those with Medicare and Medicaid.

Medicare and Medicaid currently cover GLP-1s like Ozempic and Wegovy for diabetes, but Medicare is prohibited from covering them for weight loss while only 13 state Medicaid plans do. The proposal, we intend to cover obesity drugs. According to a White House fact sheet, this proposal could support 3.4 million Medicare enrollees and reduce out-of-pocket costs for these drugs by 95% for some beneficiaries. In addition, 4 million older Medicaid enrollees will have access to medications.

The Health Equity Coalition for Chronic Disease called the announcement “a huge step forward.” This organization focuses on reducing barriers in communities of color when it comes to treatment for chronic diseases.

“Communities of color are disproportionately impacted by obesity, which is why we’ve long urged policymakers to expand Medicare and Medicaid coverage to include a full range of obesity treatment options — including greater access to effective treatments, screenings, and anti-obesity medications. ,” said the leaders of this organization in a statement. “Today’s action will not only help millions achieve better health outcomes, but it will bring us closer to creating an equitable health care system — one that has long excluded millions who face barriers to getting the care they need and deserve.”

The Alliance for Women’s Health & Prevention (AWHP) also publicly supported the White House’s announcement but noted that the final decision is now in the hands of the Trump administration. This non-profit organization focuses on women’s preventive health and leads the EveryBODY ​​Covered campaign, which works to increase obesity care coverage.

“We know obesity has a huge impact on women – especially women of color – at all stages of life. … But insurance barriers often put the full range of obesity care options — especially medications — out of reach for most Americans,” said Millicent Gorham, CEO of AWHP. “Now, the responsibility to ensure comprehensive coverage of obesity care will shift to The incoming Trump-Vance Administration will ultimately decide whether to implement this change. It is our greatest hope that chronic diseases such as obesity are the focus of the incoming administration, and we look forward to working with them to finalize and implement this legislation.”

One GLP-1 inclusion advocate hopes the incoming administration will support the proposal but said there may be some opposition from Robert F. Kennedy Jr., Trump’s pick for secretary of the Department of Health and Human Services.

“RFK Jr.’s stated position was one of lifestyles focused solely on treating obesity,” said Brooke Boyarsky Pratt, founder and CEO of knownwell, a weight management company. “We have 30 years of research to show that most Americans cannot ‘diet and exercise’ their way out of obesity in the long term. What Americans need is a comprehensive approach, including treatment, to improve long-term chronic disease. We hope that the new administration will demand comprehensive, clinical-based care – which should include lifestyle factors, but also hopefully open the way for high-quality treatment.”

The proposed legislation comes as nearly 42% of Americans are obese, and these medications appear to be effective in supporting weight loss. However, without insurance coverage, the drugs can cost $1,000 a month, according to the announcement.

Photo: Jason Dean, Getty Images