Biden Administration Proposes Medicare and Medicaid Coverage for Weight-Loss Drugs Like Wegovy

Millions of Americans struggling with obesity could soon have access to life-changing weight-loss medications like Wegovy and Ozempic under a new rule proposed by the Biden administration. Announced Tuesday by the U.S. Department of Health and Human Services (HHS), the plan aims to expand Medicare and Medicaid coverage for these expensive but highly effective treatments.

The proposed rule, which has the potential to transform obesity care in the U.S., comes with a staggering price tag of up to $35 billion over the next decade. Currently, these drugs are only covered in certain cases, such as for individuals with diabetes or those at risk for severe health conditions like heart disease or stroke. The new rule would extend coverage to anyone classified as obese—defined as having a body mass index (BMI) of 30 or higher.

“It’s a good day for anyone who suffers from obesity,” said HHS Secretary Xavier Becerra in an interview with The Associated Press. “It’s a game changer for Americans who can’t afford these drugs otherwise.”

The weekly injectables, which have gained widespread popularity, are known for helping patients shed significant amounts of weight in relatively short periods. Despite their success, they remain out of reach for many due to their high cost.

The rule is not expected to be finalized until January, after President-elect Donald Trump takes office. While the proposal has bipartisan support in Congress, some members of Trump’s incoming administration are signaling resistance.

Robert F. Kennedy Jr., Trump’s nominee to head the Department of Health and Human Services, has been an outspoken critic of weight-loss medications, raising questions about whether the proposal will survive. Additionally, conservative allies in Trump’s circle have voiced concerns about the $35 billion cost, which could conflict with their goal of cutting government spending.

Supporters of the rule argue that the long-term savings could outweigh the initial expense. Obesity is a leading cause of chronic conditions like diabetes, heart disease, and stroke, which cost the government billions in healthcare spending annually. By addressing obesity directly, proponents say, the government could significantly reduce the financial burden of treating related health issues.

Not everyone would qualify for coverage under the proposed rule. Only individuals with a BMI of 30 or higher would be eligible, limiting the scope of the program to those officially classified as obese. While this leaves out individuals seeking the drugs for other reasons, such as mild weight management, it keeps the focus on addressing obesity as a medical condition.