Biden Admin. Proposes Expanding Coverage of Weight-Loss Drugs

The 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]