Late
last
week,
the
Trump
administration’s
CMS
announced
that
it
is
not
finalizing
a
provision
proposed
by
the
Biden
administration
that
would
expand
coverage
of
anti-obesity
drugs
under
Medicare
and
Medicaid.
Currently,
Medicare
and
Medicaid
are
required
to
cover
GLP-1s
like
Ozempic
and
Wegovy
for
conditions
like
diabetes,
but
Medicare
is
prohibited
from
covering
them
for
weight
loss
and
only
some
state
Medicaid
programs
do.
The
proposed
rule
released
in
November
would
have
expanded
coverage
to
obesity
as
well.
The
Trump
administration’s
decision
left
some
healthcare
leaders
disappointed,
including
Millicent
Gorham,
CEO
of
the
Alliance
for
Women’s
Health
&
Prevention,
a
women’s
health
advocacy
organization.
Last
year,
the
organization
launched
a
campaign
called
EveryBODY
Covered,
which
aims
to
expand
coverage
of
obesity
care.
“We
are
deeply
disappointed
by
CMS’
decision
not
to
finalize
the
proposed
rule
to
expand
coverage
of
obesity
management
medications
under
Medicare
Part
D
and
Medicaid,”
Gorham
said
in
a
statement.
“Obesity
is
a
chronic,
yet
treatable,
disease
that
has
a
significant
impact
on
Americans—and
particularly
American
women
—
throughout
their
lives.
This
change
would
have
been
transformative
for
the
millions
of
individuals
living
with
obesity
who
rely
on
these
programs
to
access
needed
care,
and
would
have
helped
to
lessen
the
impact
of
the
over
200
other
health
complications
associated
with
the
disease.”
An
executive
from
Vida
Health
argued
that
this
decision
to
not
cover
weight
loss
drugs
for
obesity
shows
that
there
is
more
work
to
be
done
in
recognizing
obesity
as
a
“debilitating
disease.”
Vida
Health
is
a
digital
company
treating
chronic
conditions.
“When
responsibly
prescribed
and
included
in
a
broader
program
that
addresses
nutrition
and
lifestyle,
these
medications
play
a
critical
role
in
weight
loss
and
managing
chronic
conditions,”
said
Veeneta
Lakhani,
chief
strategy
and
development
officer
of
Vida
Health,
in
an
email.
“This
decision
limits
access
to
GLP-1s
for
many
patients
who
would
benefit,
which
furthers
existing
health
disparities
and
inequality
in
obesity
care.”
Another
healthcare
executive
pointed
out
that
GLP-1s
are
covered
for
comorbidities
often
associated
with
obesity,
such
as
sleep
apnea
and
cardiovascular
disease,
but
not
for
the
root
cause
itself.
She
argues
that
these
medications
should
be
covered
for
obesity
as
well
as
these
comorbidities.
“We
need
to
start
treating
obesity
as
the
serious
chronic
disease
that
it
is,
rather
than
treating
the
secondary
diseases
that
are
brought
on
by
it.
Zepbound
is
only
covered
if
you
suffer
from
sleep
apnea,
and
Wegovy
is
only
covered
if
you
have
cardiovascular
disease
–
but
to
get
to
the
root
of
both
issues,
we
need
to
be
able
to
treat
the
underlying
cause,
which
affects
nearly
half
of
the
American
population,”
said
Dr.
Angela
Fitch,
chief
medical
officer
and
co-founder
of
weight
care
company
knownwell,
in
an
email.
Currently,
more
than
42%
of
adults
in
the
U.S.
have
obesity.
Without
insurance,
the
cost
of
weight
loss
drugs
can
range
from
a
few
hundred
dollars
to
$1,500
per
month.
It’s
possible
that
CMS
will
reconsider
covering
these
drugs
in
the
future,
according
to
a
blog
post
from
the
Medicare
Policy
Initiative.
There
have
also
been
other
proposals
to
expand
coverage
of
anti-obesity
medications,
including
bills
in
Congress.
It’s
worth
noting,
however,
that
Robert
F.
Kennedy
Jr.,
secretary
of
the
U.S.
Department
of
Health
and
Human
Services,
has
been
critical
of
weight-loss
drugs
in
the
past
and
has
instead
stressed
the
importance
of
lifestyle
changes.
Photo:
Jason
Dean,
Getty
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