Biden Administration Proposes Expanded Coverage of Anti-Obesity Medications for Medicare and Medicaid Enrollees

Proposal Overview:
The Biden-Harris Administration has proposed a new rule to significantly expand coverage of anti-obesity medications for Americans with Medicare and Medicaid14.

Impact:
The proposal aims to help an estimated 3.4 million Americans with Medicare and approximately 4 million adult Medicaid enrollees gain new access to these medications1.

Cost Reduction:
Medicare coverage would reduce out-of-pocket costs for these prescription drugs by as much as 95% for some enrollees1.

Health Benefits:
Anti-obesity medications can help prevent the development of Type 2 diabetes and reduce deaths and sickness from heart attack and other cardiovascular outcomes by up to 20%1.

Comprehensive Agenda:
The proposed rule is part of a broader effort to lower drug prices, including the drug price negotiation program and increased market competition1.

Previous Efforts:
The Biden-Harris Administration has already implemented measures to lower prescription drug costs, such as capping insulin at $35 and out-of-pocket costs for prescription drugs at $2,000 starting in 20251.

International Comparison:
Americans pay two to three times more than people in other countries for their prescription drugs, highlighting the need for cost reduction measures1.

Sources:

1. https://www.whitehouse.gov/briefing-room/statements-releases/2024/11/26/fact-sheet-biden-harris-administration-takes-latest-step-to-lower-prescription-drug-costs-by-proposing-expanded-coverage-of-anti-obesity-medications-for-americans-with-medicare-and-medicaid/

4. https://www.usatoday.com/story/news/health/2024/11/26/medicare-cover-weight-loss-drugs-wegovy/76579654007/