(The Center Square) \u2013 President Joe Biden plans to require Medicare and Medicaid to offer coverage for weight-loss medications, a move that could cost $36 billion for the two federal programs over the next decade.\u00a0<\/p>\n
The new rule could significantly expand access to anti-obesity drugs such as Ozempic and Wegovy. Without insurance coverage, the drugs can cost as much as $1,000 a month.<\/p>\n
Lawmakers previously prohibited Medicare from paying for weight loss drugs unless those drugs are used to treat diabetes or manage heart disease risks.<\/p>\n
The White House said an estimated 42% of the U.S. population has obesity, which is “a chronic disease, with increased risk of all-cause mortality and multiple related comorbidities such as diabetes, cardiovascular disease, stroke, some cancers, and more.”<\/p>\n
The new proposal would expand access to medications for obesity. The White House said it would help an estimated 3.4 million Americans with Medicare and\u00a0 about 4 million adult Medicaid enrollees.<\/p>\n
“This proposal would allow Americans and their doctors to determine the best path forward so they can lead healthier lives, without worrying about their ability to cover these drugs out-of-pocket, and ultimately reduce health care costs to our nation,” according to a White House statement.<\/p>\n
Under Biden’s plan, the federal government would pick up most of the costs. That’s about $25 billion for Medicare and $11 billion for Medicaid over the next decade. States would be on the hook for another $3.8 billion.\u00a0<\/p>\n
The proposal requires a 60-day public comment period before it can go into effect, meaning it would be up to the incoming Trump administration to complete it.\u00a0<\/p>\n
Medicare provides federal health insurance for people 65 or older, and some people younger than 65 with certain disabilities or conditions. Medicaid is a joint federal and state program that helps cover medical costs for some low-income people.<\/p>\n
U.S. Rep. Wiley Nickel, R-N.C., praised the move.\u00a0<\/p>\n
“Today’s announcement to expand Medicare & Medicaid coverage for anti-obesity medications is a big step forward,” he wrote on X. “I’ve been a strong advocate for this change because it will improve lives and lower health care costs.”<\/p>\n
Others have warned about the cost, including U.S. Sen. Bernie Sanders, I-Vermont.\u00a0<\/p>\n
“The good news is that HHS recognizes that vitally important anti-obesity medicines like Wegovy and Zepbound should be made available to all Americans, regardless of income,” Sanders said in a statement. “The bad news is that unless Medicare demands that Novo Nordisk and Eli Lilly substantially reduce the prices for these anti-obesity drugs, Medicare premiums for all seniors would skyrocket.”<\/p>\n
He said drug prices must come down.<\/p>\n
“If this proposal is to be financially responsible for seniors and taxpayers, Medicare and Medicaid cannot pay up to 10-15 times more for these drugs than they cost in Europe and other major countries,” Sanders said. “We cannot allow Medicare and Medicaid to simply be a cash cow for Novo Nordisk and Eli Lilly.”<\/p>\n","protected":false},"excerpt":{"rendered":"
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