Biden Medicare plan to drastically expand GLP-1 access

The Biden administration has proposed a new rule that could significantly expand Medicare and Medicaid coverage for obesity medications, potentially benefiting millions of Americans.

The proposed changes would reinterpret Medicare Part D rules to cover obesity drugs, such as Wegovy (semaglutide) and Mounjaro (tirzepatide), specifically for weight management, marking a departure from current policies that restrict coverage to other conditions like type 2 diabetes or cardiovascular disease.

This expansion would enable approximately 3.4 million Medicare beneficiaries and 4 million Medicaid enrollees to gain access to these treatments, reducing out-of-pocket expenses by up to 95% for some patients. The cost could exceed $40 billion over the next decade.