Millions More Americans to Gain Access to Anti-Obesity Meds, Says Biden Administration
The Biden administration has proposed a plan to expand access to anti-obesity medications, benefiting approximately 3.4 million Medicare beneficiaries and 4 million Medicaid recipients. The drugs, which can cost up to $1,000 a month for the uninsured, aim to treat and manage obesity as a chronic disease.
Under the proposal, Medicare and Medicaid would cover the medications for weight reduction and maintenance, reducing out-of-pocket costs by as much as 95% for some Medicare recipients. The plan would also allow Americans to “lead healthier lives without worrying about their ability to cover these drugs out-of-pocket,” the White House said.
The Centers for Medicare and Medicaid Services (CMS) is reinterpreting a statute to allow coverage for treatment of obesity as a chronic disease, as the medical community increasingly recognizes it as a serious condition increasing the risk of premature death and other health issues.
The expanded coverage would not apply to those who are overweight, only to those with obesity. The proposal would cost an estimated $25 billion over a decade for Medicare and $11 billion and $3.8 billion respectively for Medicaid, with no short-term impact on drug plan premiums.
The plan’s success is uncertain, as it may be pending approval by the incoming administration and could be subject to changes or reversal. The proposal has faced criticism from Dr. Robert F. Kennedy Jr., who has advocated for providing Americans with access to healthy food instead. However, Dr. Mehmet Oz, tapped to head the Centers for Medicare and Medicaid Services, has expressed support for anti-obesity drugs.
The proposal comes as the high cost of anti-obesity drugs has limited their access. The list price for some medications can be as high as $1,350 for a four-week supply. The administration’s plan could lead to broader coverage and greater availability of these medications, potentially reducing health care costs and improving public health.
