Trump admin won't let Medicare cover anti-obesity drugs
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The Trump administration on Friday scrapped a Biden administration proposal to have Medicare cover anti-obesity drugs, including GLP-1s.
Why it matters: The decision sidelines a politically popular idea that had big implications for the program's finances.
Driving the news: A Medicare payment rule issued Friday would maintain a long-standing prohibition on covering drugs for weight loss.
- The Biden administration argued that reinterpreting the existing policy would have made the drugs more accessible to millions of Americans and potentially lower the prevalence of obesity-related illnesses.
- Medicare administrators may revisit the policy in the future, according to a fact sheet on the rule.
Catch up quick: Requiring Medicare and Medicaid to cover GLP-1s like Wegovy for weight loss would have cost the government nearly $40 billion over 10 years.
- Medicare currently covers the drugs to treat diabetes and heart disease.
- In nearly 25,000 comments to CMS on the policy, many individuals described their own positive experiences with the drugs. But insurers urged CMS not to finalize the change.
Between the lines: Prior to being nominated, HHS Secretary Robert F. Kennedy Jr. panned the use of Ozempic and other GLP-1 drugs for weight-loss.
- But he took a softer stance during his Senate confirmation hearings, calling the products "miracle drugs" for obesity and diabetes while saying they shouldn't be prescribed without exercise.
Zoom out: The rule issued Friday also didn't adopt Biden administration proposals on health equity analyses of how health services are managed, and guardrails for using artificial intelligence in Medicare Advantage.
- The administration did finalize technical updates to Medicare Advantage risk adjustment data collection and other smaller proposals.
What they're saying: "As we continue to review the final rule, we are encouraged that the administration took a measured approach and declined to make major changes at this time," Mary Beth Donahue, CEO of the Better Medicare Alliance, said in a statement.
