Medicare drug plans may soon include coverage for anti-obesity medications, as indicated in draft regulations set to be published in December 2026. According to the Centers for Medicare & Medicaid Services (CMS), obesity is now being recognized as a chronic disease, though being overweight is not yet classified similarly. This proposal is designed to address the needs of patients who require weight loss to combat health conditions such as diabetes. However, it does not extend to overweight patients seeking weight reduction for non-medical reasons.
CMS estimates that treating obesity as a chronic disease could lead to an additional $24.8 billion in federal spending over the next decade. Currently, federal spending on Medicare drug plans is projected to reach approximately $1.8 trillion from 2025 to 2034, as projected by the Congressional Budget Office.
Stakeholders will have until January 27th to submit their comments on this proposal. The regulatory outline is bundled with various other provisions, including the use of artificial intelligence in Medicare plan decisions and rules for insurance agents marketing Medicare Advantage plans.
The administration’s choices for leadership positions are noteworthy: Robert F. Kennedy Jr., the incoming head of the U.S. Department of Health and Human Services, is reportedly skeptical about using drugs for weight management. Conversely, Dr. Mehmet Oz, nominated to lead CMS, has expressed positive opinions about drugs like Wegovy, which could benefit patients with heart disease.
For a detailed analysis, read the original article from ThinkAdvisor.