Proposed Rule Would Expand Medicare And Medicaid Coverage For Anti-Obesity Medications

Health Affairs December 17, 2024
Rachel Sachs

On Tuesday, November 26, the Centers for Medicare and Medicaid Services (CMS) proposed a new statutory interpretation that, if finalized, would result in expanded Medicare and Medicaid coverage for anti-obesity medications (AOMs). This expanded coverage would potentially include the new class of GLP-1 agonists, such as Wegovy. These products mimic the naturally occurring hormone glucagon-like peptide-1, which helps the body both feel full faster and longer, leading to less food intake, and produce more insulin, lowering blood sugar.

In this article, I explain the legal and policy context behind this proposed rule, describe CMS’s proposal, and explore its implications for access to and the cost of these medications.

Existing Statutory Bars To Medicare And Medicaid Coverage Of Anti-Obesity Medications

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