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Medicare won’t cover anti-obesity GLP-1 drugs as Biden admin proposed

The Centers for Medicare and Medicaid Services (CMS) announced Friday it will not be finalizing a rule proposed by the Biden administration that would have allowed Medicare and Medicaid beneficiaries access to anti-obesity drugs such as the highly in-demand GLP-1 medications.

In November last year, the Biden administration proposed a new rule that would allow drugs like Wegovy and Zepbound to be covered by Medicare and Medicaid, expanding access for roughly 3.4 million Medicare users and about 4 million Medicaid enrollees.

But in a notice released Friday, the CMS said it would not be finalizing this proposed rule, providing no further details.

Medicare does cover GLP-1 drugs when prescribed for conditions like diabetes and heart disease, but legislation from 2003 prohibits Medicare from covering drugs for weight loss.

There is a bipartisan push in Congress to allow for anti-obesity drugs and services to be covered through a bill called the Treat and Reduce Obesity Act (TROA), but it failed to advance in the last Congress.

Under the Biden administration’s proposal, older and/or low-income Americans with a body mass index of 30 or higher would have qualified for coverage for the drugs.

Health and Human Services Secretary Robert F. Kennedy Jr. has criticized GLP-1 medications like Ozempic in the past, claiming in interviews that these drugs are being pushed onto Americans by foreign companies who don’t sell the same product in their home countries.

Kennedy has instead focused on lifestyle changes for combatting obesity, though he told CNBC last year that GLP-1s “have a place” in treating the disorder. Newly confirmed CMS Administrator Mehmet Oz has spoken favorably of GLP-1 drugs, previously saying on social media that the benefits offered by these medications are “massive.”

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