WASHINGTON — The Biden administration is proposing a major expansion of how Medicare and Medicaid cover the blockbuster weight-loss drugs Wegovy and Zepbound, the White House announced Tuesday.
Medicare currently covers the medications made by Novo Nordisk and Eli Lilly to treat diabetes and heart disease, but not for obesity alone because it’s prohibited by law from doing so. Given the price tag, a bill in Congress to extend coverage has stalled for years. Advocates for greater coverage have long argued that Medicare had the power to change coverage policy on its own.
The White House estimates the new proposal would provide coverage to an estimated 3.4 million older adults in the Medicare program, and 4 million people in Medicaid.
“Medicare coverage would reduce out-of-pocket costs for these prescription drugs by as much as 95% for some enrollees,” the White House said Tuesday.
The Trump administration’s pick for Health and Human Services secretary, Robert F. Kennedy Jr., has criticized anti-obesity medications. It’s unclear whether he would support such a measure, or would work to roll it back.
While the medications have high sticker prices on their own — they can cost about $1,000 a month out of pocket — they are widely expected to be part of Medicare’s next round of drug price negotiations, which would take effect in 2027.