Biden Admin. Proposes Expanding Coverage of Weight-Loss Drugs
The US Department of Health and Human Services (HHS) on Tuesday announced it's proposing a rule making Medicare and Medicaid recipients eligible to have the cost for weight-loss drugs, including Wegovy and Zepbound, covered starting in 2026.
Facts
- The US Department of Health and Human Services (HHS) on Tuesday announced it's proposing a rule making Medicare and Medicaid recipients eligible to have the cost for weight-loss drugs, including Wegovy and Zepbound, covered starting in 2026.[1]
- The rule, which wouldn't be finalized until January, would open coverage to anyone considered obese — a body mass index of 30 or higher. The Biden administration estimates an additional 3.5M Medicare enrollees and 4M people on Medicaid would qualify.[2]
- The Congressional Budget Office estimates the government would have to spend $35B over 10 years for Medicare expansion. Congress has failed to pass a bill to expand this type of coverage for more than a decade.[3]
- These drugs are said to help patients lose 15%-25% of their body weight by regulating appetite, with monthly costs sitting at around $1K-$1.3K.[4]
- This rule may face obstacles after Pres.-elect Donald Trump is inaugurated in January. His nominee for HHS secretary, Robert F. Kennedy Jr., opposes these weight-loss drugs and instead endorses helping Americans eat healthier and work out more.[4]
Sources: [1]USA Today, [2]Associated Press, [3]STAT and [4]Newsweek.
Narratives
- Democratic narrative, as provided by The New York Times and NBC. This is a smart move to make these drugs available to more people and allow obese people to treat their condition before they have to deal with more serious diseases. This expansion will also help close the gap between wealthy individuals who can already access the drugs and low- and middle-income people who haven't been able to obtain them. It'd be wise for Trump to stay out of the way of this popular rule taking effect.
- Republican narrative, as provided by Daily Mail and Daily Caller. The Biden administration is trying to sabotage Trump's attempt to fulfill his promise of cutting federal spending by forcing him to consider stopping an expensive-but-popular rule from taking effect. But Americans elected Trump to take on the establishment, including Big Pharma, and Kennedy will lead the battle and show the electorate better ways to get healthy without risking harmful side effects.
