Washington (AP) The Biden administration proposed a new regulation Tuesday morning that would allow Medicare or Medicaid to pay popular weight-loss medications like Wegovy or Ozempic for millions of obese Americans.
The U.S. Department of Health and Human Services’ expensive proposal sets the stage for a possible confrontation between the influential pharmaceutical industry and Robert F. Kennedy Jr., a vocal opponent of weight-loss medications who may attempt to thwart the measure as President-elect Donald Trump’s nominee to head the agency.
The rule would cost taxpayers up to $35 billion over the next ten years, even though it would provide millions of people with monthly injectables that have helped patients lose weight so swiftly that some have dubbed them miracle medications.
In an interview with The Associated Press, U.S. Health and Human Services Secretary Xavier Becerra said, “It’s a good day for anyone who suffers from obesity.” For Americans who would not otherwise be able to buy these medications, it is a game changer.
Congressmen from both parties have pushed for Medicare to cover the medications, arguing that doing so could prevent the government from spending billions of dollars on treating obesity-related chronic illnesses. Trump’s stance on the weight-loss medications is uncertain, but his supporters and Cabinet picks, who have pledged to reduce government spending, might object to the initial cost.
FILE – U.S. Department of Health and Human Services Secretary Xavier Becerra speaks in Sacramento, Calif., Oct. 29, 2024. (AP Photo/Rich Pedroncelli, File)
Pictured by Rich Pedroncelli/Associated Press
Only people who are deemed obese—defined as having a body mass index of 30 or higher—would be eligible for coverage under the idea. If a person has diabetes or is at risk for heart disease or stroke, they may already be covered by Medicare or Medicaid.
According to Becerra, an extra 4 million Medicaid recipients and 3.5 million Medicare beneficiaries might be eligible for the medications. However, research indicates that a much larger number of people may be eligible; according to the Centers for Medicare and Medicaid Services, almost 28 million Medicaid recipients are obese.
A decades-old restriction that forbids the government-sponsored insurance program from paying for weight-loss items has prevented Medicare from providing the medications. However, the Biden administration’s proposed rule would acknowledge obesity as a medical condition that may be addressed with medication.
With the Food and Drug Administration authorizing a new class of weekly injectables, like as Novo Nordisk’s Wegovy and Eli Lilly’s Zepbound, to treat obesity, the market for anti-obesity medications has grown dramatically in recent years.
The medications mimic the hormones that control hunger by letting the brain and gut know when a person is full, causing them to shed as much as 15% to 25% of their total weight.
Due to their high cost, the medications are mostly only available to the wealthy, including famous people who brag about their advantages. Zepbound will cost you $1,000 per month, while Wegovy costs $1,300. Drug shortages have also made supply scarcer.
Kennedy has blasted the drug’s popularity and is awaiting Senate confirmation as Trump’s candidate for HHS secretary. He has stated in speeches and on social media that the United States should not use Medicaid or Medicare to pay for the medications. Rather, he is in favor of a wide extension of coverage for gym memberships and healthier diets.
Kennedy told a gathering of federal politicians during a roundtable earlier this year that we could buy organic, regeneratively grown food for every American, three meals a day, and a gym membership for every obese American for half the cost of Ozempic.
The Associated Press, 2024. All rights reserved. All rights reserved. It is prohibited to publish, broadcast, rewrite, or redistribute this content without authorization.
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