Illustration: Tiffany Herring/Axios
Legislation that would make Medicare cover blockbuster weight-loss drugs took its first step forward today when House Ways and Means overwhelmingly voted to advance the Treat and Reduce Obesity Act.
Why it matters: Although TROA has been introduced every Congress for the last decade, the 36–4 vote signaled wide bipartisan support in the bill's first-ever markup.
- Key to the bill's approval was a chairman's amendment limiting coverage to people who are diagnosed as obese and who have been taking the drugs at least one year before enrolling in Medicare.
- The narrower criteria will almost certainly reduce the CBO score and ease concern about drugs like Wegovy and Zepbound putting a financial strain on the program. W&M health staff director Patrick Dumas said the pared-down bill was estimated to cost $1.7 billion over 10 years.
Zoom in: It remains to be seen whether the bill will receive a floor vote, but it's a priority for Rep. Brad Wenstrup, a longtime cosponsor who's retiring at the end of this Congress and is close to Majority Leader Steve Scalise.
Driving the news: Committee Democrats during the markup debated whether the bill would benefit only certain groups and isn't equitable.
- Rep. Lloyd Doggett raised the specter of only wealthy individuals who've accessed the drugs on generous private health plans being able to have costs covered by Medicare.
- Rep. Gwen Moore countered that individuals on Medicaid who similarly are already taking the drugs would also gain Medicare coverage.
- Rep. Don Beyer also said that getting Wegovy and Zepbound into the Medicare system was a good way to start lowering the prices of the drugs by making them eligible for Medicare drug price negotiations.
- A Democratic amendment that would allow all Medicare beneficiaries to access weight-loss drugs was rejected.
The committee also advanced other health bills addressing Medicare coverage of "breakthrough" medical devices and cognitive impairment detection.
- The bill that would extend coverage for devices approved under the FDA's Breakthrough Devices Programs was approved 36–5.
- Legislation to extend Medicare coverage to multi-cancer early detection screening tests and a bill that would allow Medicare to add a cognitive impairment benefit were unanimously approved.
