Thursday, February 20, 2025

Advocates Push for Medicare and Medicaid to Cover Anti-Obesity Medications

A coalition of nearly 20,000 advocates and a dozen major health care groups are urging the Centers for Medicare & Medicaid Services (CMS) to expand coverage to include FDA-approved anti-obesity medications. If approved, the rule change could impact up to 7.5 million Americans enrolled in federal health programs.

A Call for Change Amid an Escalating Crisis

Obesity rates in the U.S. have climbed at an alarming rate, with about 42% of American adults now living with the condition. Experts predict that by the next decade, that number will surpass 50%. As obesity fuels chronic illnesses like diabetes and heart disease, the associated health care costs continue to balloon, draining an estimated $173 billion from the U.S. economy each year.

Dr. Elena Rios, co-chair of the Health Equity Coalition for Chronic Disease (HECCD) and president of the National Hispanic Health Foundation, emphasized the potential benefits of expanding Medicare and Medicaid coverage for these treatments. She pointed out that older adults in rural and underserved areas suffer disproportionately from obesity, yet they remain excluded from receiving effective treatments due to outdated policies.

“Expanding Medicare & Medicaid coverage policies to include anti-obesity medications will have a profound impact on improving the health of millions of Americans—especially older Americans living in rural and underserved communities,” Rios said in a statement.

Medicare Health Insurance card file folder

Bipartisan Support Highlights Growing Momentum

Efforts to expand federal coverage for obesity treatments have gained bipartisan support, reflecting a broad acknowledgment of obesity as a public health emergency rather than a lifestyle issue. The advocacy push is spearheaded by groups such as the Alliance for Patient Access, the League of United Latin American Citizens (LULAC), and the Obesity Care Advocacy Network.

A public comment letter submitted by grassroots organizations underscored the urgency of the issue, pointing out that communities of color and rural populations bear a disproportionate burden. According to the letter, obesity rates in these communities are six times higher than those in urban and suburban areas, exacerbating existing health disparities.

For many, the push isn’t just about covering weight loss drugs. It’s about preventing conditions like type 2 diabetes and cardiovascular disease—illnesses that cost billions in medical expenses annually. Advocates argue that by covering anti-obesity medications, Medicare and Medicaid would not only improve health outcomes but also reduce long-term costs associated with obesity-related diseases.

Potential Roadblocks and Concerns

While support for this policy change is strong, there are lingering concerns. Critics argue that relying on medications instead of lifestyle interventions—such as diet and exercise—could lead to an overmedicalization of obesity treatment. Others worry about the financial strain on already stretched federal health care budgets.

Some key concerns include:

  • High Costs: Many of these medications are expensive, and expanding coverage could significantly increase federal spending.
  • Long-Term Efficacy: Questions remain about the sustainability of weight loss from anti-obesity medications.
  • Side Effects & Safety: Some experts caution that we don’t yet have enough long-term data on potential side effects of certain drugs.

Dr. Eleanor Yusupov, an obesity medicine physician and assistant professor at New York Institute of Technology’s College of Osteopathic Medicine, stressed the importance of access. “The high cost of anti-obesity treatments and lack of insurance coverage remain major barriers for patients who need these medications,” she said. “Too often, our most disadvantaged patients are unable to obtain highly effective treatments that could prevent diabetes and improve overall health.”

How This Could Reshape Health Care Policy

If CMS approves the expansion, it would mark a significant policy shift. Medicare and Medicaid would officially recognize obesity as a chronic disease requiring medical treatment, aligning with clinical standards set by the American Medical Association and other health organizations.

To put this into perspective, here’s a comparison of how current policies treat obesity versus the proposed changes:

Current Medicare/Medicaid Policy Proposed Changes
Coverage for bariatric surgery but no coverage for obesity medications Inclusion of FDA-approved anti-obesity drugs
Recognizes obesity as a risk factor but not as a standalone disease Treats obesity as a chronic disease, similar to diabetes
Limited weight loss counseling covered Comprehensive obesity treatment, including medications and counseling

Advocates believe this shift could usher in broader reforms that recognize and address obesity as a serious health condition rather than a personal failing.

What Comes Next?

The public comment period for the proposed rule has officially closed, meaning CMS will now review the feedback and decide whether to move forward with expanding coverage. If approved, the new policy would reshape the way obesity is treated under federal health programs, potentially setting a precedent for private insurers to follow suit.

For millions of Americans struggling with obesity—many of whom are unable to afford treatment—this decision could be life-changing. As the country waits for CMS to make its final call, one thing is clear: the conversation around obesity is no longer just about weight—it’s about health equity, financial sustainability, and the future of public health policy.

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