ACP urges Medicare expansion to cover obesity medications

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The American College of Physicians (ACP) is urging federal action to expand Medicare and Medicaid coverage of obesity medications following growing evidence supporting glucagon-like peptide-1 (GLP-1) receptor agonists, including semaglutide—Ozempic and Wegovy—for weight loss and diabetes management.

“Through advocacy, we hope to expand access to these medications as well as any other evidence-based treatments for individuals with obesity,” said Shari Erickson, chief advocacy officer and senior vice president of governmental affairs and public policy at ACP.

New evidence

A systematic review, published in the Annals of Internal Medicine, found that GLP-1 receptor agonists and dual or triple co-agonists were “efficacious for weight loss,” with randomized controlled trials demonstrating long-term weight reduction of 5.8% to 22.1%, compared to a placebo. Although gastrointestinal side effects were present, discontinuation rates were low.

Despite these results, insurers have been reluctant to cover the high cost of these drugs when prescribed for obesity.

Legislative push

ACP is backing former President Biden’s proposal that would require Medicare and Medicaid to extend coverage of GLP-1 receptor agonists beyond diabetes to include obesity treatment. The regulation now awaits a final decision from the Trump administration, with ACP set to submit comments in the near future.

“ACP supports coverage of medications that are U.S. Food and Drug Administration-approved for obesity and for treatment of diabetes,” Erickson said in an ACP release. “Our hope is that the Trump administration will finalize the regulation.”

Robert F. Kennedy Jr., President Trump’s nominee for Secretary of the U.S. Department of Health and Human Services (HHS), has previously voiced skepticism about GLP-1 receptor agonists like Ozempic. In a Fox News interview, he argued that addressing nutrition could be a more effective solution to the obesity epidemic, stating, “If we just gave good food, three meals a day, to every man, woman and child in our country, we could solve the obesity and diabetes epidemic overnight.”

However, Erickson noted that Kennedy has also been an advocate for chronic disease treatment, suggesting that there is a strong case for GLP-1 medications as part of a broader strategy to manage obesity-related conditions.

The push for broader coverage aligns with ACP’s Advancing Equitable Obesity Care Initiative, which also offers an Obesity Management Learning hub with educational modules, patient materials and research updates from leading journals.

In addition to regulatory efforts, ACP supports the Treat and Reduce Obesity Act, which was first introduced to Congress in 2023, and is expected to be reintroduced. The bill would allow the Medicare prescription drug benefit to cover medications for obesity treatment and weight loss management in patients who are overweight.

The initial bill, despite bipartisan support from 120 House cosponsors, failed to advance.

“Even if the Trump administration were to move in the direction of not finalizing the proposed regulation, this would be a way to ensure that coverage would take place,” Erickson noted, adding that while she is hopeful, she understands Congress has a long priority list.

If legislative and regulatory efforts succeed, broader access to these treatments could soon transform chronic disease management in the U.S.