Biden administration pushes to expand Medicare and Medicaid to cover weight-loss drugs

On Tuesday, the Biden administration’s top health authority announced plans to reinterpret existing rules to require Medicare and Medicaid to cover the cost of Ozempic, Mounjaro and Wegovy for people insured under their health care programs.

Current rules hinder coverage of weight-loss medications. But the White House said the Biden administration’s rule change would expand access to prescription drugs for 3.4 million people enrolled in Medicare and 4 million people on Medicaid.

The move could reduce out-of-pocket expenses for weight-loss medications by 95% for some Medicare enrollees. While the general changes will only apply to obese people, overweight registered people will not benefit from insurance unless they have another condition such as diabetes.

The news came after a broadcast to work This month shows that nearly 75% of adults living in the United States are obese or overweight.

Biden administration’s HHS plans, criticism Ozempic and other weight loss drugs have received criticism in recent months, most notably from President-elect Donald Trump. applicant He will take over the health institution in his second term.

At a congressional hearing last month, Robert F. Kennedy Jr. recommended He said Washington lawmakers and medical establishments are pressuring Ozempic because the drug’s maker, Novo Nordisk, is “one of the largest funders of medical research.”

Kennedy, who said when he supported Trump in August that sick people were “the best thing for the pharmaceutical industry” because “they have to be on drugs their whole lives,” added: “Imagine what will happen when Medicaid starts paying for Ozempic per month.” “It’s $1,500 and is recommended for children as young as six years old, all for obesity, a condition that is completely preventable and barely existed a hundred years ago.”

Kennedy stated that the Biden administration will pursue an “organic food” plan as head of HHS, rather than the approach of using weight-loss drugs to treat obesity, which is classified as a chronic disease.

“Since 74 percent of Americans are obese, the cost for Medicaid to cover Ozempic could be as high as $3 trillion a year. “With a fraction of this money, we can buy organic food for every American and get rid of diabetes completely,” he said.

While the majority of state Medicaid programs do not cover weight-loss medications solely for obesity, Medicare only covers weight-loss medications for obese or overweight people with a diagnosis of diabetes or cardiovascular disease. The drugs currently cost enrollees “up to $1,000 per month,” the White House said Tuesday.

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Senator Bernie Sanders (I-VT) criticized Novo Nordisk CEO Lars Fruergaard Jørgensen regarding high costs Ozempik and “Stop ripping us off,” Wegovy said at a Senate hearing in September.

His remarks come as lawmakers have been pushing for more than a year for the Treating and Reducing Obesity Act of 2023, which would require insurance companies to cover Ozempic’s costs.