Medicare won’t cover anti-obesity drugs like Ozempic and Zepbound for its beneficiaries, the Centers for Medicare and Medicaid Services have announced.
In November 2024, the Biden administration proposed that weight-loss drugs should be covered by Medicare and Medicaid, which would have expanded access to almost 7.5 million Americans.
Older and low-income Americans with a body-mass index of more than 30 would have qualified under the rule. The expanded cover was estimated to cost taxpayers $35 billion over the next decade; although members of Congress on both sides said the cost would save many billions more in healthcare costs associated with obesity.
On Friday, however, the Centers for Medicare and Medicaid released a final ruling that coverage would not be extended.
Although weight-loss medications can already be covered by Medicare for conditions like heart disease and diabetes, a 2003 law prevents the program from covering medication that is used directly for weight loss.
Medicare and Medicaid administer health coverage payments for more than 160 million people, spending one in five taxpayer dollars through Medicare, Medicaid, the Children’s Health Insurance Program, and the Health Insurance Marketplace.
Robert F. Kennedy Jr., who heads the Department of Health and Human Services, has been a vocal critic of weight-loss medication, suggesting that it does nothing to solve the underlying causes of ill health.
During the election campaign, he said that if “every man, woman and child in our country” was given “good food, three meals a day… we could solve the obesity and diabetes epidemic overnight.”
Nevertheless, in December, as he was awaiting confirmation, Secretary Kennedy said drugs like Ozempic “have a place” in fighting obesity.
More than 200 million Americans are now overweight or obese.
Since 1990, rates have doubled. Around half of all adolescents in the US are overweight or obese, and three-quarters of adults.
Researchers have forecast that by 2050 more than 80% of adults and 60% of adolescents will be overweight or obese if current trends continue.
With 208 million overweight or obese people, the US has one of the highest rates of overweight and obesity worldwide.
Research has shown that obesity accounted for 335,000 deaths in 2021 in the US alone. Obesity is one of the most important and fastest-growing risk factors for chronic disease and early death.
Obesity also has enormous economic implications. A Congressional report published in 2024 predicted that obesity-related health costs will rise to $9.1 trillion over the next decade.