President Biden Proposes Medicare and Medicaid Coverage for Weight-Loss Medications
President Joe Biden has unveiled a plan that would require Medicare and Medicaid to offer coverage for weight-loss medications, potentially costing $36 billion for the two federal programs over the next decade.
The proposed rule aims to broaden access to anti-obesity drugs like Ozempic and Wegovy, which can be prohibitively expensive without insurance coverage, costing up to $1,000 per month.
Previously, Medicare was restricted from paying for weight loss drugs unless they were used to treat diabetes or manage heart disease risks.
The White House cited that approximately 42% of the U.S. population suffers from obesity, a chronic disease associated with various health risks such as diabetes, cardiovascular disease, stroke, and certain cancers.
If implemented, the new proposal would provide access to obesity medications for an estimated 3.4 million Americans with Medicare and around 4 million adult Medicaid enrollees.
The federal government would cover most of the costs, amounting to $25 billion for Medicare and $11 billion for Medicaid over the next decade, with states responsible for an additional $3.8 billion.
While U.S. Rep. Wiley Nickel, R-N.C., praised the initiative for improving lives and reducing healthcare costs, others like U.S. Sen. Bernie Sanders, I-Vermont, have expressed concerns about potential premium increases and the need for drug price reductions.
Sanders emphasized the importance of Medicare and Medicaid not overpaying for medications compared to other countries, urging for responsible pricing to benefit seniors and taxpayers.
The proposal is subject to a 60-day public comment period before implementation, requiring further review by the incoming administration.
Medicare provides health insurance for individuals aged 65 and older, as well as certain younger individuals with disabilities, while Medicaid assists in covering medical expenses for low-income individuals.
Syndicated with permission from The Center Square.
