It marks a major shift in policy towards coverage of obesity drugs

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Proposed experiment would allow states and Medicare drug plans to cover GLP-1 drugs like Ozempic and Wegovy for obesity, The Washington Post reports.
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Marks a major shift in public insurance policy as costs, benefits, and long-term outcomes are evaluated.
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Final decision still pending; coverage could begin as early as 2026 for Medicaid and 2027 for Medicare.
The Trump administration is preparing a five-year pilot program that could pave the way for millions of obese Americans on Medicare and Medicaid to gain access to popular and expensive weight-loss drugs, including Ozempic, Wegovy, Mounjaro, and Zepbound.
According to internal documents from the Centers for Medicare and Medicaid Services (CMS), obtained by The Washington Post, the plan would allow states and Medicare Part D insurers to voluntarily cover these drugs for obesity management. Currently, Medicare only covers GLP-1 medications for Type 2 diabetes, while some private insurers cover them for weight loss.
The proposal, expected to launch in April 2026 for Medicaid and January 2027 for Medicare, would be overseen by the CMS Innovation Center (CMMI), which pilots novel healthcare payment and care models aimed at lowering costs and improving outcomes.
A reversal From previous policy
The experiment comes just months after the administration officially rejected a Biden-era proposal to allow Medicare and Medicaid to cover GLP-1 drugs for obesity treatment. Chiquita Brooks-LaSure, CMS Administrator under Biden, praised the plan as potentially transformative. Increased coverage of anti-obesity medications in Medicare and Medicaid was a priority during my tenure, she said.
While the plan isnt finalized and may bypass public comment, it reflects a growing openness among federal policymakers to treat obesity as a chronic disease deserving pharmaceutical intervention.
Despite the optimism among some officials, the proposed expansion is facing political and financial headwinds. The Congressional Budget Office estimates the cost of Medicare covering these drugs for obesity could hit $35 billion from 2026 to 2034.
Trump officials appear divided. CMS Administrator Mehmet Oz has publicly praised GLP-1s, while HHS Secretary Robert F. Kennedy Jr. has warned about their cost and the risk of using them in place of healthy lifestyle changes.
Health influencers in Trump-aligned wellness circles including Jillian Michaels and Mark Hyman have also criticized the drugs, citing concerns over metabolism disruption and weight regain once treatment stops. Critics argue the nation cant afford a lifelong drug regimen for the estimated 100 million obese Americans.
David Rind, chief medical officer at the Institute for Clinical and Economic Review, said the drugs offer immense individual health benefits and are priced reasonably, with annual costs ranging from $5,000 to $7,000. But, he added, In the aggregate, this is terrifying. I just dont know how our nation is going to pay for this.
The road ahead
It remains uncertain how many states and Medicare plans will opt into the voluntary experiment, or whether the Trump administration will finalize the proposal. Insurers have reportedly lobbied hard against broad coverage due to financial concerns.
Still, the test program could be a first step toward reshaping how the U.S. health system tackles obesity not just as a lifestyle issue, but as a condition requiring ongoing medical treatment.
Posted: 2025-08-01 15:52:24