The drugs have been shown to have numerous health benefits, but Medicare is prohibited from covering “weight loss” drugs for anything other than treating conditions such as diabetes or heart disease. Currently, only 13 states cover GLP-1 drugs for obesity under Medicaid.
A proposal announced by the Biden administration last November would require Medicare and Medicaid coverage of weight loss drugs for people with obesity. To sidestep the restriction, the Centers for Medicare and Medicaid Services said obesity would be considered a chronic disease.
However, a final Medicare payment rule issued late Friday will maintain the current prohibition.
The proposed rule drew nearly 25,000 comments, many of which urged the agency to move forward with the policy. But insurers were against it, because of the extremely high price tag — which also could have contributed to the Trump administration’s decision not to enact it.
Authorizing coverage of anti-obesity medications in Medicare would increase federal spending by about $35 billion from 2026 to 2034, according to the Congressional Budget Office. It would apply to about 3.4 million people with Medicare and 4 million people with Medicaid.
Health and Human Services Secretary Robert F. Kennedy Jr. previously said he thinks the drugs are a scam, and the solution to obesity is to simply eat better. However, he told senators during his confirmation hearing GLP-1 drugs are a “miracle” for obesity and diabetes.
