A newly proposed rule from the Department of Health and Human Services would expand coverage of obesity management medications for patients in the Medicare and Medicaid programs.
Millions of Americans living with this chronic disease may soon have coverage for the medications they need to help improve their quality of life.
Access to Obesity Treatment
An estimated 7.4 million Americans will benefit from the proposed rule. Without health plan coverage for their obesity medication, patients can pay as much as $1,000 a month in out-of-pocket costs—a significant expense for most Americans.
This proposed rule updates CMS rules that have, to date, not recognized obesity as a chronic disease. Historically, Medicare rules restricted Part D coverage of medications for weight loss. The new proposal reinterprets this language to recognize obesity management treatments as chronic disease care, not cosmetic care.
The Chronic Disease Millions of Americans Face
Since 2013, the American Medical Association has recognized obesity as a chronic disease. Despite the stigma and discrimination associated with chronic obesity, the medical community has remained clear that this is a serious condition and it needs to be treated as such.
The health risks associated with obesity have been climbing in recent years.
Obesity is commonly seen alongside hypertension, diabetes, asthma and osteoarthritis. Obesity in adults costs the United States roughly $200 billion per year, with much of that being attributed to obesity-related diseases.
The benefits of obesity management medication, on the other hand, have been evident for over a decade. The first GLP-1 receptor agonist medication was approved for obesity management.
Ensuring Patient Access
The new proposal is cause for celebration among the 40% of American adults living with obesity, and the advocates who have been working to fix this oversight for many years.
The full HHS ruling will be published on December 10 on the Federal Register where comments may be submitted.
