Administration Rejects Medicaid, Medicare Plan To Cover Obesity Drugs
The Biden-era plan, scrapped Friday, would have cost the federal government billions of dollars and expanded access to millions of Americans. Meanwhile, states are struggling with the rising cost of GLP-1 drugs.
The New York Times:
Trump Rejects Proposal For Medicare To Cover Wegovy And Other Obesity Drugs
The Trump administration on Friday rejected a Biden plan that would have required Medicare and Medicaid to cover obesity drugs and expanded access for millions of people. Under the law that established Medicare’s Part D drug benefits, the program was forbidden from paying for drugs for “weight loss.” But the Biden administration’s proposal last November had attempted to sidestep that ban by arguing that the drugs would be allowed to treat the disease of obesity and its related conditions. (Sanger-Katz and Robbins, 4/4)
AP:
High Cost Of Weight-Loss Drugs Strains State Medicaid Programs
States increasingly struggling to cover the rising cost of popular GLP-1 drugs like Wegovy, Ozempic and Zepbound are searching for ways to get out from under the budgetary squeeze that took them by surprise. One solution some policymakers may try is restricting the number of people on Medicaid who can use the pricey diabetes drugs for weight-loss purposes. Pennsylvania’s Medicaid coverage of the drugs is expected to cost $1.3 billion in 2025 — up from a fraction of that several years ago — and is contributing to projections of a multibillion-dollar budget deficit. (Haigh and Levy, 4/6)
More Medicaid news —
The New York Times:
The Three States That Are Especially Stuck If Congress Cuts Medicaid
If congressional Republicans go through with some of the deep Medicaid cuts they are considering, three states would be left in an especially tight bind. South Dakota, Missouri and Oklahoma have state constitutions requiring that they participate in Medicaid expansion, the part of Obamacare that expanded the health program for the poor to millions of adults. (Kliff and Sanger-Katz, 4/6)
KFF Health News:
The House Speaker’s Eyeing Big Cuts To Medicaid. In His Louisiana District, It’s A Lifeline
When Desoto Regional Health System took out $36 million in loans last year to renovate a rural hospital that opened in 1952, officials were banking on its main funding source remaining stable: Medicaid, the joint federal-state health program for low-income people and the disabled. But those dollars are now in jeopardy, as President Donald Trump and the GOP-controlled Congress move to shrink the nearly $900 billion health program that covers more than 1 in 5 Americans. (Galewitz, 4/7)
WOSU Public Media:
Ohio's GOP Still Wants Medicaid Work Requirements Despite Other States' 'Administrative Nightmare'
Ohio plans to add work requirements for people insured under the Medicaid expansion, even after hearing that efforts to do this in other states did not lead to more employment, just less access to health care. (Fox, 4/7)