If a brand new experiment pans out, Medicaid and Medicare may start overlaying the expensive weight-loss medication that value out many People who may wish to strive them.
After killing a Biden-era plan with the identical aim, the Trump administration is engaged on a five-year pilot program that may enable state Medicaid applications and Medicare’s prescription plan to decide into overlaying medication like Ozempic, Wegovy, Zepbound, and Mounjaro for “weight administration,” The Washington Put up studies.
Throughout its closing months, the Biden administration proposed increasing Medicaid and Medicare protection for fashionable weight-loss medication, extending it to roughly 7.5 million individuals enrolled in these applications.
In April, the Trump administration tossed that plan—a transfer that was considerably anticipated, given Well being and Human Providers Secretary Robert F. Kennedy Jr.’s vocal opposition to the weight-loss medication which have taken America by storm. Now, one thing very related seems to be again on the desk.
Variations of opinion
Kennedy’s view is at odds with different members of the Trump administration, together with Dr. Mehmet Oz, the administrator of the Facilities for Medicare and Medicaid Providers (CMS). Oz, a former surgeon finest often called a daytime tv persona previous to becoming a member of the federal authorities, has lengthy boosted weight-loss medication like Ozempic.
“I’ll respect you it doesn’t matter what your weight is perhaps, however for many who wish to lose just a few kilos, Ozempic and different semaglutide drugs generally is a huge assist,” Oz stated in a social media submit in 2023. “We have to make it as simple as doable for individuals to satisfy their well being targets, interval.”
Oz has been paid to advertise the medication previously. In 2019, Ozempic maker Novo Nordisk sponsored a nine-minute-long infomercial on Oz’s daytime discuss present praising the advantages of utilizing Ozempic for Kind 2 diabetes.
On the opposite aspect of the coin, Kennedy at HHS is staunchly against weight-loss medication like Ozempic and has made deceptive claims in regards to the class of medicine previously. “They’re relying on promoting it to People as a result of we’re so silly and so hooked on medication,” Kennedy stated in an interview he shared on Instagram final yr.
Kennedy, a distinguished determine in anti-vaccine circles earlier than becoming a member of the Trump administration, has an extended monitor file of elevating well being conspiracy theories, even whereas selling different commonsense concepts round well being and wellness. Kennedy, who opposes using many prescription drugs, believes that the prominence of processed meals within the American weight-reduction plan is a root explanation for most of the nation’s well being woes.
What’s the standing now?
Whereas Medicaid and Medicare don’t evenly cowl GLP-1 medication like Ozempic for weight reduction, 13 state Medicaid applications do supply protection to deal with weight problems. For individuals on Medicaid and Medicare, protection is rather more broadly obtainable when GLP-1 medication are prescribed for Kind 2 diabetes.
The Washington Put up studies that the trial program is slated to start out in April 2026 for Medicaid and in January 2027 for Medicare. This system is related to the Middle for Medicare and Medicaid Innovation, which experiments with new methods to decrease prices and ship protection for individuals enrolled in these backed insurance coverage applications.
In accordance with paperwork considered by The Put up, this system has but to be finalized. Whether or not it goes into impact or not, the experimental plan to increase protection exhibits that the anti-Ozempic faction of the Trump administration may discover itself overruled on the subject of the weight-loss drug.