Washington Post National Health Reporter Paige Winfield Cunningham discusses how the Trump administration is considering healthcare coverage for weight loss drugs.

The US government is planning a five-year experimental program that would allow some Medicare and Medicaid recipients with obesity to access weight loss drugs, including Ozempic, Wagovi, Manjaro, and Zep-Bound. Currently, Medicare covers these drugs primarily for patients with type 2 diabetes or coronary disease, while Medicaid coverage varies by state.

The proposed trial would begin for Medicaid in 2026 and for Medicare in 2027, with participation optional for state programs and insurers. The initiative reflects ongoing debate within the administration about the long-term value and cost of covering these expensive medications for obesity. While some health experts support expanded access, concerns remain about the financial impact, with estimates suggesting the cost could reach $35 billion for Medicare over a decade, without sufficient healthcare savings to offset expenses.

Medicare, Medicaid to experiment with covering weight loss drugs

In America, it's estimated that over 40 percent of adults are struggling with obesity. According to an exclusive report in the Washington Post, the government wants to start treating it like a medical problem, not simply a personal failing, by giving access to those on Medicare and Medicaid. Thus, the Trump administration is considering a five-year experiment that would give some overweight Americans access to expensive weight-loss drugs such as Ozempic, Wagovi, Manjaro, and Zep-Bound. According to the Post, this trial would start for Medicaid in April of 2026, Medicare in January of 2027. Many health experts believe that expanded coverage is the wave of the future. Here to discuss her exclusive report from the Washington Post is the national health reporter, Paige Winfield Cunningham. Paige, thank you so much for being here. What is currently covered, and how is that about to change in the experiment? Yes, well, right now, Medicare and about 12 state Medicaid programs do cover, well, sorry, let me back up. Medicare right now pays for these GLP-1 drugs, these weight-loss drugs, but only for people generally speaking with type 2 diabetes, some people with coronary disease, because that's what the FDA has approved these medications for. So the question now on the table is whether they would pay for these medications for people with obesity. And last spring, the Trump administration said, no, they're not going to. There was big concern, as you said, of course, about cost. But what's significant is I obtained documents from HHS which show that they're thinking about experimenting basically by allowing Medicare plans and state Medicaid programs to opt in to start covering these drugs for people with obesity. It's kind of a backdoor way to try to do this. And I think it reflects some divisions in the Trump administration over whether these drugs should be for people with obesity and whether it's worth paying for them over the long term. So your reporting acknowledges, and I remember reading in the past that there's apparently a division between Dr. Oz and Bobby Kennedy, Secretary Kennedy, in terms of how they look at this. Does this mean that Dr. Oz in the short term won that debate? So the way they're doing it is kind of through this experiment lab that exists within HHS. And it exists for the purpose of trying out new ways of paying for health care. And so it does have limited scope. They can't mandate that plans or states opt into this. And of course, that's a big question. These drugs are expensive. So I don't know how many insurers or states are going to actually want to do this. But yes, this is sort of a way for us to start experimenting with it, potentially see what happens, see how many opt in, see what kind of health outcomes we see for obese patients that go on these medications. But you're right. There are some tensions here. RFK Jr. has expressed some concerns about this, you know, replacing diet and exercise and those traditional means of losing weight. And of course, there are many voices in the Maha universe that have also expressed skepticism. I actually spoke this week with Dr. Mark Hyman, who's been out there, very skeptical. And he worries that these drugs could perhaps change the metabolism for patients long term. So if they ever go off these drugs, it could be hard to and gain the weight back. It could be hard to lose weight again. So I think it'll be really interesting to see how this plays out and what ultimately comes of this experiment. Final thought. To me, it's you can pay me now or you can pay me later. We're talking, I guess, about 100 million Americans who are obese at an annualized cost of five to seven thousand dollars. You say that's staggering. How in the world could we afford to provide that coverage? But if you don't provide the coverage and people continue to carry that body mass and get into trouble later in life, we end up paying for them then. So maybe we're better paying now. Your final thought. Yeah. So I asked a doctor about this this week and he loves these drugs. He prescribes them to patients all the time and he sees on an individual basis what they do for somebody. They lose this weight. Their life's their life improves. They can do things. That's what they used to be able to do. But even he acknowledges that just the scale of Americans that could benefit from these drugs around 100 million people, that is enormous cost for the government, about thirty five billion dollars for Medicare over the next 10 years. And even the Congressional Budget Office has said that you wouldn't achieve enough health care savings to counteract that enormous cost. So it's a it's a real problem. And I think one the government has to grapple with. Congratulations on your report. Paige Winfield Cunningham. Appreciate it.

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