Trump Administration Rejects Plan to Include Anti-Obesity Medications in Medicare Coverage
The Trump administration has decided against including coverage for costly and highly sought-after obesity treatments under Medicare.
The Centers for Medicare and Medicaid Services (CMS) announced Friday that these medications would not be covered under Medicare’s Part D prescription drug plan, which primarily serves individuals aged 65 and older.
Former President Joe Biden had proposed a rule in late November, following Trump’s re-election, to extend coverage to drugs like Zepbound and Wegovy. However, the rule was not expected to be finalized before Trump assumed office.
Trump returned to office in January, and the Senate confirmed Dr. Mehmet Oz as the head of CMS on Thursday.
CMS did not provide a reason for its decision on Friday, and federal representatives have yet to respond to requests for comments.
Robert F. Kennedy Jr., Trump’s Secretary of Health and Human Services, has been a vocal critic of the injectable drugs, which have gained immense popularity due to their potential for significant weight loss.
Surveys indicate that Americans generally support Medicare and Medicaid coverage of these drugs. However, many insurers, employers, and other payers are hesitant due to the widespread potential use and high monthly costs, which can reach hundreds of dollars.
Biden’s proposal, which would have included coverage for all state and federally funded Medicaid programs for low-income individuals, was projected to cost taxpayers up to $35 billion over the next decade.
Supporters of the coverage argue that treating obesity can lead to long-term cost reductions by preventing heart attacks and other severe health issues associated with the condition.
According to the benefits consultant Mercer, 44% of U.S. companies with 500 or more employees covered obesity drugs last year.
Medicare currently covers drugs like Wegovy for patients with heart disease who need to lower their risk of future cardiovascular events. The program also covers versions of these drugs used to treat diabetes.
Over a dozen state Medicaid programs already provide coverage for obesity drugs.
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