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Biden Proposes Medicare and Medicaid Coverage for Weight Loss Drugs

Tuesday, November 26, 2024 by Emma Garcia

Biden Proposes Medicare and Medicaid Coverage for Weight Loss Drugs
Obese man in the U.S. (Reference image) - Image by © Flickr/ Steve Baker

With just two months remaining in his presidency, Joe Biden has unveiled a proposal to include weight loss medications, such as Wegovy and Ozempic, in the coverage provided by Medicare and Medicaid. This initiative, which recognizes obesity as a treatable chronic condition, has the potential to assist millions of Americans by significantly lowering the costs of these medications, which currently exceed $1,000 per month, as reported by Telemundo.

Over 40% of the American populace is classified as obese, prompting the need for expanded access to treatments previously reserved for individuals with diabetes or related health issues. According to Health Secretary Xavier Becerra, the proposed coverage could extend to an additional 3.5 million Medicare recipients and 4 million Medicaid beneficiaries, in addition to the over 28 million Medicaid members who already meet obesity criteria.

Political Challenges and Future Hurdles

Though the initiative is backed by a bipartisan coalition in Congress, it faces substantial obstacles. Telemundo noted that the incoming administration under Donald Trump might obstruct its implementation. Trump's nominee for Health Secretary, Robert F. Kennedy Jr., has voiced opposition to these drugs, advocating instead for investments in nutritious foods and gyms as more cost-effective alternatives.

The obesity medication market, led by Wegovy from Novo Nordisk and Zepbound from Eli Lilly, has seen rapid growth in recent years. These drugs, which are based on semaglutide, mimic a hormone that controls appetite, potentially enabling patients to shed 15% to 25% of their body weight. Nevertheless, their high cost and limited availability have restricted access, predominantly benefiting those with higher incomes.

Economic and Social Implications

The proposal, which could be finalized by January, shortly after Trump's inauguration, is estimated to cost $35 billion over the next decade. Proponents argue that it could ultimately lead to considerable savings by reducing expenditures on chronic diseases associated with obesity, such as diabetes and heart disease.

This policy shift not only stands to revolutionize the treatment of obesity in the United States but also sparks a debate over equitable access to medications. A recent study highlighted that 85% of semaglutide prescriptions in 2023 were dispensed to white individuals, leaving lower-income communities and other ethnic groups with limited options.

The controversy surrounding this proposal underscores a growing dilemma between public health costs and the urgent need to address one of the nation's most significant health crises, amid a pivotal political transition. Recently, the Biden administration announced the issuance of an additional 64,716 temporary H-2B work visas for the fiscal year 2025, aimed at non-agricultural workers. These will supplement the 66,000 visas previously approved by Congress, bringing the total to over 130,700, the maximum permitted under current legislation.

This announcement followed a cordial meeting in the Oval Office between outgoing President Joe Biden and President-elect Donald Trump to formalize the power transition. It is anticipated that Trump's administration will implement measures affecting illegal immigrants, though he remains committed to not disrupting the workforce in the United States. This visa approval is vital for many individuals in Latin America and the Caribbean.

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