Trump officials plan coverage for weight loss drugs under Medicare and Medicaid

The Guardian

4 days ago

The Trump administration is planning a pilot program to cover 'miracle' weight loss drugs under the government health insurance systems for low-income people and retirees, Medicaid and Medicare, in a move aimed at tackling the US's chronic obesity problem.
Such a plan was previously proposed by the Biden administration in its final months before Donald Trump re-entered the White House after winning a second term in office in the 2024 election.
Now the Trump administration intends a five-year experiment in which the Medicaid program and Medicare drug coverage plans will have the option of covering the cost of drugs selling under the names Ozempic, Wegovy, Mounjaro and Zepbound for 'weight management' purposes, the Washington Post reported on Friday morning, citing documents from the government's Centers for Medicare & Medicaid Services (CMS).
This type of medication, known as GLP-1 drugs and originally developed to treat type 2 diabetes, have gained popularity for their ability to reduce body weight by suppressing appetite and slowing digestion.
But their high cost, typically between $5,000 and $7,000 a year, has raised concerns about long-term affordability and such a plan now under consideration by Donald Trump would come at a hefty cost to the public purse.
Insurance coverage for such drugs is currently typically approved when patients have other conditions that are often tied to obesity, such as diabetes, heart disease and cancer.
The new proposed plan would permit state Medicaid programs and Medicare Part D insurance plans to voluntarily cover GLP-1 drugs, including those from the market leaders Novo Nordisk and Eli Lilly, the report said.
Lilly and Novo are leaders in the weight-loss drug market, which some analysts expect could bring in more than $150bn in revenue by the next decade. Lilly's shares were up nearly 2% in premarket trading on Friday.
The initiative is slated to begin in April 2026 for Medicaid and January 2027 for Medicare. If it clears the way, it would mark a shift in federal policy after the administration said earlier this year that the programs would not cover weight loss drugs.
The Centers for Medicare & Medicaid Services, Lilly and Novo did not respond to Reuters' request for comment.
The plan could expose division between CMS head Mehmet Oz, who has previously praised such drugs, and health secretary Robert F Kennedy Jr, who has criticized their high cost and how they are not a substitute for a healthy lifestyle.