Biden Admin Proposes Medicare and Medicaid Coverage for Weight Loss Drugs

The Biden Administration proposed granting widespread coverage of weight loss drugs by Medicare and Medicaid services, on Tuesday. 

The Details: Beneficiaries would need to have a BMI of 30 or higher in order to be eligible for the so-called “miracle treatments,” such as Wegovy, Zepbound and Ozempic, which are currently only covered for those with certain obesity-related conditions. The proposal came from the U.S. Department of Health and Human Services (DHHS), and its results will not be finalized until shortly after President-elect Donald Trump takes office. Trump recently nominated Robert F. Kennedy Jr.– who supports government investments in preventive measures for weight control, rather than weight loss drugs– to lead the DHHS.

For Context: Around 40% of Americans reportedly have obesity, though statistics vary between sources. The proposal has been estimated to cost around $3.5B per year, if approved; but, according to the White House, it would “reduce out-of-pocket costs for [prescription drugs] by as much as 95 percent for some enrollees.” Ozempic, for instance, costs about $1,000 per month without insurance coverage. 

How the Media Covered It: The proposal reportedly has some bipartisan support from Congress, due to the potential for coverage to lower government spending on obesity-related illnesses; however, media outlets across the spectrum highlighted the prospective clash between the proposal and Kennedy, who reportedly once said, “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.”