By I. Edwards HealthDay Reporter<\/b>
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MONDAY, April 7, 2025 (HealthDay News) — The Trump administration has decided not to expand Medicare and Medicaid coverage for popular obesity drugs, blocking a Biden administration initiative that could have helped millions of Americans access the medications.<\/p>\n
Catherine Howden<\/a>, a spokeswoman for the Centers for Medicare & Medicaid Services, said that expanding coverage for these drugs \u201cis not appropriate at this time,\u201d though it “may consider future policy options\u201d for them.<\/p>\n The decision was included in a 438-page rule updating other parts of Medicare\u2019s drug coverage.<\/p>\n Currently, Medicare covers these drugs only for people with diabetes<\/a>, or in rare cases, for those who are obese and also have major heart problems or sleep apnea<\/a>, The New York Times <\/em>reported.<\/p>\n Former President Joe Biden’s plan would have expanded access to people who are obese but do not have other health problems.<\/p>\n Officials estimated that about 3.4 million more people might start using the medications if coverage were expanded.<\/p>\n The drugs include Novo Nordisk\u2019s Wegovy<\/a> and Ozempic<\/a>, and Eli Lilly\u2019s Zepbound<\/a> and Mounjaro<\/a>. These medications have shown benefits beyond weight loss, such as lowering the risk of heart attacks and strokes<\/a>.<\/p>\n But cost was a major concern. The Congressional Budget Office estimated that expanding coverage would cost the federal government around $35 billion over 10 years, The Times <\/em>said.<\/p>\n Retail prices for the drugs range from $350 to $500 per month without insurance, according to The Times<\/em>.<\/p>\n Compounded versions, made during shortages, have cost less than $200 — but regulators plan to stop allowing those soon.<\/p>\n Some Medicaid programs already cover these drugs. Others don\u2019t.<\/p>\n Proponents argue that the drugs would save money in the long run by preventing costly health issues. However, it\u2019s still unclear whether those savings would actually happen.<\/p>\n Many private health plans also don\u2019t cover these drugs. Some, like state employee plans in North Carolina and West Virginia, dropped coverage after demand and costs soared.<\/p>\n More information<\/strong><\/p>\n The Social Security Administration has more on the plan for Medicare<\/a>.<\/p>\n