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In a groundbreaking move, the Biden administration has proposed a $35 billion plan to provide millions of obese Americans with access to popular weekly injectables that can help them shed pounds quickly. However, the proposal’s fate hangs in the balance, as it requires approval from President-elect Donald Trump, who has not yet indicated whether he will support the initiative.
The proposed rule, unveiled on Tuesday by the Health and Human Services Department, would require Medicare and Medicaid to cover weight-loss drugs like Wegovy or Zepbound for a large segment of Americans who are obese. This move is expected to benefit millions of people who are struggling with obesity, a condition that increases the risk of various health problems, including diabetes, heart disease, and certain types of cancer.
However, it is unclear whether the proposal will receive support from Trump’s new administration, particularly from Robert F. Kennedy Jr., who has been tapped to serve as head of the Health and Human Services Department. Kennedy has been a vocal opponent of the weight-loss drugs, arguing that they are not a long-term solution to the obesity epidemic and that more emphasis should be placed on promoting healthy lifestyles.
The weight-loss drugs in question, also known as anti-obesity medications or GLP-1s, work by mimicking the hormone glucagon-like peptide 1, which regulates appetite by communicating fullness between the gut and brain when people eat. Clinical trials have shown that these drugs can be highly effective in helping people lose weight, with some participants losing up to 50 pounds or more.
The proposed rule would affect Medicaid, which provides health care coverage for roughly 70 million of the nation’s poorest people, and Medicare, the health insurance program for about 67 million older Americans. Under the proposal, the Centers for Medicare and Medicaid Services would reinterpret the federal law to consider the weight-loss drugs as a treatment for obesity diseases.
According to estimates, as many as 3.5 million people on Medicare and 4 million on Medicaid could qualify for coverage of the weight-loss drugs. However, research suggests that far more people might qualify, with the Centers for Medicare and Medicaid Services estimating that roughly 28 million people on Medicaid are considered obese.
The proposal would come with a hefty price tag, with estimates suggesting that it would cost at least $35 billion over the next decade. However, proponents of the plan argue that it could ultimately save taxpayers money in the long run by reducing the economic burden of obesity-related health problems.
The weight-loss drugs have gained popularity in recent years, with a majority of Americans telling health firm KFF in a poll earlier this year that Medicare should cover the drugs. A bipartisan coalition of lawmakers has also lobbied for coverage of the drugs, arguing that they are a crucial tool in the fight against obesity.
However, not everyone is convinced that the proposal is a good idea. Some lawmakers have expressed skepticism about the plan, arguing that it could lead to increased costs for Medicare premiums. Sen. Bernie Sanders has warned that unless the government requires drugmakers to lower the price of the medications, Medicare premiums could “skyrocket” under the plan.
Dr. David Ludwig, a nutrition and obesity expert at Harvard University, hopes that the proposal does not become the primary way obesity is treated in America. While he acknowledges that the weight-loss drugs can be effective, he worries that not enough investment is being made to figure out what is driving climbing obesity rates across the U.S., and the role that healthy foods and exercise might play in solving that epidemic.
Dr. Andrew Kraftson, who treats obese patients at the University of Michigan, is happy that more of his patients might be able to afford the weight-loss drugs, which he has prescribed for patients and has had successful results. However, he also worries about some of the side effects for elderly patients, particularly muscle loss, which can be a bigger problem for older Americans who are at risk of falling.
As the debate over the proposal continues, one thing is clear: the fight against obesity is a complex and multifaceted issue that requires a comprehensive approach. While the weight-loss drugs may be a useful tool in this fight, they should not be seen as a silver bullet. Rather, they should be used in conjunction with other strategies, such as promoting healthy lifestyles and addressing the root causes of obesity.
