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The Trump Administration rejected a Biden initiative to have Medicare cover obesity drugs

The decision was announced as part of a 438-page rulemaking, updating programs that cover beneficiaries' drugs.

Obesity drugs.

Obesity drugs.Cordon Press.

Joaquín Núñez
Published by

2 minutes read

The Trump administration rejected a Biden-era initiative to make Medicare and Medicaid cover obesity drugs. The decision was announced as part of a 438-page rulemaking, updating the programs that cover beneficiaries' medications.

The plan was introduced in November 2024 by the previous Democratic administration. According to his estimates, it would have cost $35 billion over 10 years, reaching about 3.4 million people.

""For too many Americans, these critical treatments are too expensive and therefore out of reach. Without insurance coverage, these drugs can cost someone up to $1,000 per month," the White House said at the time.

The announcement came just a day after the Senate confirmed Mehmet Oz as administrator of the Centers for Medicare and Medicaid Services (CMS). Catherine Howden, a CMS spokeswoman, said in an email that they believe expanding this type of coverage "is not appropriate at this time." At the same time, she added that it is not completely ruled out and that future policy options "for these drugs" could be considered.

Currently Medicare, the government health insurance program for people over 65, covers drugs for patients with diabetes and a much smaller group of people with obesity and other conditions, such as heart problems or sleep apnea. The Biden Administration's proposal would have expanded coverage for patients with obesity but without the aforementioned additional conditions.

Medicare's ban on coverage of obesity medications

This ban began in 2003, when Congress passed the Medicare Prescription Drug Improvement and Modernization Act of 2003. It was the biggest "Part D" reform in 38 years. This section includes the entire Medicare-covered drug benefit.

During the last Congress there was a bipartisan bill to allow obesity drugs and services to enter coverage. However, the Treatment and Reduction of Obesity Act (TROA) failed to advance through either chamber.

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