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In a move that underscores the changing perception around obesity as a disease, the Biden administration announced Tuesday that it wants Medicare and Medicaid to begin covering GLP-1 drugs for weight loss.

The proposed rule marks one of Biden’s final health policy announcements before the end of his term, when President-elect Donald Trump will take power in January.

Medicare and Medicaid currently only cover GLP-1 drugs for diabetes, even as the number of patients using them for weight loss has skyrocketed in recent years.

People who don’t have employer coverage for the drugs and are seeking prescriptions for weight loss often have to pay out-of-pocket. This can be a pricey endeavor, often reaching near $1,000 per month.

Currently, only certain U.S. employers cover GLP-1s for obesity, though this has been changing recently as well. 

About one-third of employer health plans now cover the drugs for obesity in addition to diabetes, a jump from 26% in 2023, according to an International Foundation of Employee Benefit Plans survey released in June.

The White House emphasized that obesity is widely recognized as a disease, noting the proposal would help an estimated 3.4 million people receive coverage through Medicare. 

The rule would also lower out-of-pocket costs for GLP-1s by up to 95% for some enrollees and expand access to an additional 4 million people.

“This proposal would allow Americans and their doctors to determine the best path forward so they can lead healthier lives, without worrying about their ability to cover these drugs out-of-pocket, and ultimately reduce healthcare costs to our nation,” the White House wrote in a statement.

For the last few decades, the obesity problem in America has grown, with about 40% of the population living with the disease. 

However, since GLP-1 drugs exploded onto the market in recent years, the obesity rate slowed down, according to data from the Centers for Disease Control and Prevention (CDC).

Still, further progress has been limited by societal stigmas related to obesity along with 20-year-old legislation that prevents Medicare and Medicaid from covering any drugs for weight loss.

Crucially, Biden’s proposed rule circumvents that restriction by defining the drugs as treating the disease of obesity and its associated conditions, like heart disease.

Going forward, the proposal depends on whether the incoming administration supports it. 

Trump’s picks for heading the Department of Health and Human Services (HHS) and Centers for Medicare and Medicaid Services (CMS), Robert F. Kennedy, Jr. and Dr. Mehmet Oz, respectively, may have differing viewpoints.

Kennedy, for one, has been vocally against the pharma industry’s solutions to obesity, arguing instead that the focus should be on obesity prevention through healthy, non-processed foods and exercise. 

On the other hand, Oz has praised GLP-1s and previously noted that “we need to make it as easy as possible for people to meet their health goals — period.”

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The Biden administration also used the proposal as an opportunity to tout its efforts to reduce the cost of prescription drugs, including through the new Medicare negotiations process included in the Inflation Reduction Act.

Allowing Medicare and Medicaid to cover GLP-1s for obesity would be part of Biden’s final drug access and pricing efforts as he closes out his presidency.

“The proposed rule would be implemented at the same time as a comprehensive agenda to lower the costs of drugs, including the drug price negotiation program and increased market competition,” the Biden administration wrote.