President Donald Trump has revealed a significant expansion of Medicare, introducing coverage for certain weight-loss medications. This initiative marks a pivotal moment for millions of older Americans seeking access to these treatments. Announced on November 6, this agreement includes drug manufacturers Eli Lilly and Novo Nordisk and focuses on lowering costs for popular weight-loss drugs such as Ozempic and Wegovy.
Key Components of the Medicare Deal
Starting in 2026, Medicare and Medicaid beneficiaries will see substantial price reductions for GLP-1 medication, which treats diabetes and obesity. The White House has shared that:
- Ozempic’s price will decrease from $1,000 to about $350 per month.
- Wegovy will drop from $1,350 to the same $350 monthly rate.
- Other upcoming medications could be priced as low as $145 per month.
These discounted rates will be available through the newly launched TrumpRx.gov website from January 2026.
Background and Legislative Changes
Pivotal changes to Medicare’s policies have emerged following recent FDA approvals of new uses for drugs like Wegovy. Previously, Medicare was not allowed to cover weight-loss drugs due to the restrictions of the 2003 Medicare Modernization Act. However, these recent approvals, particularly for cardiovascular health benefits, have prompted Medicare to reevaluate coverage options.
Moreover, the Centers for Medicare & Medicaid Services (CMS) has indicated that Part D plans can now include specific weight-loss drugs in their formularies, provided there is a medically acceptable use.
Financial Implications of Expanded Coverage
The fiscal ramifications of this expanded Medicare coverage are considerable. The Congressional Budget Office (CBO) projects an increase in federal spending of at least $35 billion from 2026 to 2034 for these anti-obesity medications. In 2026, the average cost per user is estimated at around $5,600, though competitive pricing may mitigate some of these expenses over time.
As the national debt surpassed $38 trillion recently, experts and budget watchdogs have raised concerns over the sustainability of such spending practices. Organizations like the Committee for a Responsible Federal Budget are closely monitoring the potential long-term effects on America’s financial health.
Conclusion
This new Medicare initiative will transform access to weight-loss medications for America’s seniors. However, the accompanying fiscal challenges present critical questions about the sustainability of increased federal spending amidst growing national debt.
