A coalition of obesity-related patient advocacy groups is calling on the incoming Trump administration to finalize a proposal that would allow Medicare coverage of obesity drugs.
More than 70 organizations led by the Obesity Care Advocacy Network (OCAN) said in a statement that addressing, treating and managing obesity is key to making America healthier.
The group pointed to research showing that if nothing is done, 213 million Americans will be overweight or obese by 2050. That means hundreds of millions of people will face health complications such as diabetes, cancer, heart problems, breathing problems, and mental health problems.
“The new administration must take action to address this crisis by ensuring that Medicare and Medicaid provide comprehensive obesity care to the millions of Americans who need these services and treatments. “We must do so,” the organizations said.
In November, the Biden administration proposed allowing obesity drugs such as Novo Nordisk's Wegovy and Eli Lilly's Zepbound to be covered by Medicare and Medicaid. Although these drugs have been shown to have many health benefits, Medicare is prohibited from covering “weight loss” drugs.
To get around the restrictions, the Centers for Medicare and Medicaid Services said obesity would be considered a chronic disease.
But the rule won't go into effect unless the Trump administration wants to move forward. Two of President-elect Trump's top health care nominees have different views on the drug's benefits.
While this policy is likely to be politically popular, it could cost the program tens of billions of dollars. There is bipartisan interest in Congress to allow Medicare to cover anti-obesity drugs, but price remains the biggest hurdle.
The price tag could give pause to Trump administration officials seeking to cut spending, but it could ease pressure on lawmakers if the administration makes a decision.
“Medicare's current classifications and limitations are outdated. They are not consistent with current medical evidence, standards of care, and understanding of the disease,” the groups said. “The proposed CMS rule would address the urgent health crisis and the leading causes of 'unhealthiness' among Americans.”
