Implications of Proposed Medicare and Medicaid Coverage of Anti-Obesity Drugs
A new KFF policy watch examines the implications of new proposed regulations that would allow Medicare and require Medicaid to cover drugs used to treat obesity, including a relatively new class of highly effective but costly drugs known as GLP-1s. The Biden administration proposal reinterprets statutory language that currently prohibits coverage of drugs used for weight loss under Medicare while permitting, but not requiring, states to cover them in Medicaid. The reinterpretation reflects the current understanding of obesity as a disease and weight loss as providing clinical benefits rather than purely cosmetic ones for people with obesity. The new policy watch explores what’s known about Medicare and Medicaid coverage and spending on GLP-1 drugs and how the proposed change, if finalized under the incoming Trump administration, could expand access to these drugs as well as increase federal and state costs.
