<h1-growing Health Costs of Anti-Obesity Medications
Millions of senior citizens and low-income Americans could gain access to expensive anti-obesity medications under a new proposal by the Biden administration. The White House announced the plan, which would allow 3.4 million Medicare beneficiaries and 4 million Medicaid recipients to obtain the medications. These costs can be up to $1,000 per month for the uninsured.
### How the Plan Would Work
The proposal aims to reduce health care costs by allowing Americans and their doctors to choose the best course of treatment. However, it lacks some important details, including which drugs are included, who would qualify, and how much it would cost. It is also unclear whether the proposal will be implemented before President Joe Biden’s term ends in January.
### GLP-1 Meds for Weight Loss
Medicare Part D may cover GLP-1 medications for weight loss under the new plan [[1](https://unitedmedicareadvisors.com/blog/medicare/part-d-glp-1-drugs/)]. These medications can cost up to $1,000 per month for the uninsured and may contribute to higher Part D premiums for all Medicare beneficiaries.
### Concerns over Health Care Costs
However, concerns have been raised over the potential health care costs. The coverage expansion could cost Medicare $3 billion annually and contribute to higher Part D premiums for all beneficiaries. Additionally, fully expanding coverage of GLP-1 medications could cost $35 billion over nine years, with limited savings from improved health outcomes.
### Response from the Incoming Trump Administration
The incoming Trump administration may not support the proposal. Robert F. Kennedy Jr., the incoming head of the Department of Health and Human Services, has expressed his disapproval of the medications. He believes providing healthy food is a better way to address obesity, citing this as a less expensive option.**Trump’s Medicare Plan May Include Obesity Drugs, But Cost Is a Concern**
The Trump administration is considering a proposal to expand Medicare coverage to include anti-obesity drugs, such as Wegovy and Zepbound, which have been shown to be effective in treating obesity and related health conditions. However, the high cost of these medications has raised concerns about the potential impact on Medicare spending.
According to a Kaiser Family Foundation (KFF) analysis, about 3.6 million Medicare enrollees with cardiovascular disease could be newly eligible for Wegovy, which is approximately a quarter of Medicare enrollees with obesity or overweight. The coverage expansion could cost Medicare nearly $3 billion a year and contribute to higher Part D premiums for all beneficiaries.
The high cost of anti-obesity drugs has limited Americans’ access to these medications. The list price for Wegovy, for example, is about $1,350 for a four-week supply. Medicare is currently prohibited by law from covering drugs for obesity, but the Centers for Medicare and Medicaid Services opened the door to coverage of Wegovy for Medicare enrollees in March after the US Food and Drug Administration approved the drug for adults with cardiovascular disease who are either obese or overweight.
Only 13 states currently cover GLP-1 medications, such as Wegovy, for obesity treatment, and half of states that do not currently cover the drugs are considering adding coverage. However, many states are concerned about the cost. Not all job-based health insurance plans cover anti-obesity medications, although larger employers are more likely to offer the benefit.
The Congressional Budget Office has estimated that fully expanding GLP-1 coverage to Medicare enrollees with obesity or overweight would cost $35 billion over nine years, while the savings from improved health would be small.
Anti-Obesity Medication Coverage Expands, but Costs and Accessibility Remain Concerns
About 3.6 million Medicare enrollees with cardiovascular disease could be newly eligible for the anti-obesity medication Wegovy, according to a recent analysis by the Kaiser Family Foundation (KFF). This expansion of coverage is expected to increase Medicare spending by nearly $3 billion annually and contribute to higher Part D premiums for all beneficiaries.
Cost Concerns and Limited Coverage
A report by the Congressional Budget Office found that fully expanding coverage of GLP-1 medications, such as Wegovy, to Medicare enrollees with obesity or overweight would cost $35 billion over nine years. However, the savings from improved health outcomes would be relatively small. Currently, only 13 states cover GLP-1 medications for obesity treatment, with many states considering adding coverage due to concerns about costs.
Employer-Based Health Insurance Plans
Not all job-based health insurance plans cover anti-obesity medications, although larger employers are more likely to offer this benefit. According to KFF’s Employer Health Benefits Survey, 18% of firms with 200 or more employees cover GLP-1 drugs primarily for weight loss, and about a quarter of these firms are likely to start coverage in the next year.
How might the political landscape affect the implementation of the Biden administration’s proposal on anti-obesity drugs?
**Interview with Health Policy Expert on Growing Health Costs of Anti-Obesity Medications**
**Host (News Editor):** Good evening, and welcome to our discussion on a pressing health issue. Today, we’re exploring the growing health costs of anti-obesity medications amidst recent proposals from the Biden administration to expand access for seniors and low-income Americans. Joining us is Dr. Sarah Langston, a health policy expert. Thank you for being here, Dr. Langston.
**Dr. Langston:** Thank you for having me.
**Host:** Let’s dive right in. Can you summarize the Biden administration’s proposal regarding anti-obesity medications and whom it intends to benefit?
**Dr. Langston:** Certainly. The Biden administration announced a plan that potentially allows 3.4 million Medicare beneficiaries and 4 million Medicaid recipients to access expensive anti-obesity medications. Currently, these drugs can cost up to $1,000 per month for uninsured individuals, significantly limiting access to those in need [[1](https://unitedmedicareadvisors.com/blog/medicare/part-d-glp-1-drugs/)].
**Host:** What are the key components of the plan, and what are the concerns surrounding its implementation?
**Dr. Langston:** The proposal aims to give Americans and their healthcare providers the flexibility to choose the best treatment options. However, it lacks specifics—such as which medications will be covered, the eligibility criteria, and the costs involved. There’s also uncertainty about whether this plan will be enacted before the end of President Biden’s term in January [[1](https://unitedmedicareadvisors.com/blog/medicare/part-d-glp-1-drugs/)].
**Host:** Recently, there have been discussions regarding GLP-1 medications, such as Wegovy. What do we know about these and their potential impact on Medicare?
**Dr. Langston:** GLP-1 medications are indeed central to this conversation. If covered under Medicare Part D, these drugs could significantly impact healthcare costs, with estimates suggesting that expanded coverage could cost Medicare an additional $3 billion annually. There are concerns that these costs could lead to higher premiums for all Medicare beneficiaries. In total, fully implementing coverage for these medications could cost around $35 billion over nine years, with anticipated limited savings from improved health outcomes [[1](https://unitedmedicareadvisors.com/blog/medicare/part-d-glp-1-drugs/)].
**Host:** That raises a crucial point about costs. What are the implications of these costs for seniors and low-income Americans?
**Dr. Langston:** The high cost of anti-obesity medications is a significant barrier to access, especially for seniors and low-income individuals who are already facing financial challenges in securing healthcare. If the plan does take effect, while it may improve access to necessary medications, it could simultaneously place a financial burden on the Medicare system and its beneficiaries due to rising premiums [[1](https://unitedmedicareadvisors.com/blog/medicare/part-d-glp-1-drugs/)].
**Host:** We’ve also heard opposition to this proposal, particularly from the incoming Trump administration. How might their stance impact these plans?
**Dr. Langston:** Yes, Robert F. Kennedy Jr., the incoming head of the Department of Health and Human Services, has expressed skepticism about the effectiveness of these medications compared to providing healthier food options as a means to combat obesity. This perspective could influence future healthcare policy significantly, especially if there is a push to prioritize preventative measures over pharmaceutical interventions [[1](https://unitedmedicareadvisors.com/blog/medicare/part-d-glp-1-drugs/)].
**Host:** Thank you, Dr. Langston, for providing your insights on this critical health issue. It’s clear that the intersection of healthcare policy, costs, and access is complex and fraught with challenges. We appreciate your expertise.
**Dr. Langston:** Thank you for having me. It’s an important topic, and I hope we can navigate these challenges effectively.
**Host:** Indeed. And thank you for tuning in. We will keep you updated on the developments regarding healthcare policies and their implications for our communities. Good night!
