A recent report by the Congressional Budget Office (CBO) reveals that adding weight-loss medications like Eli Lilly's and Novo Nordisk's treatments to Medicare would cost the US $35 billion over nine years.
Covering these drugs would make an estimated 12.5 million additional Americans eligible by 2026. Currently, Medicare, which provides prescription coverage to over 52 million seniors and disabled individuals, does not include drugs specifically for weight loss.
Report: $35 Billion Cost to Medicare for Weight-Loss Drug Coverage
Advocacy groups and pharmaceutical companies are lobbying Congress to expand this coverage to include popular weight-loss treatments like Novo's Wegovy and Eli Lilly's Zepbound, which are only covered by Medicare for conditions like heart disease.
In response to these demands, Congress requested a cost assessment from the CBO, with the results highlighting significant expenses for potential Medicare expansion.
According to the CBO report, covering these drugs could incur annual costs of up to $7 billion by 2034. This expense could potentially be offset by modest savings, with an estimated $1 billion saved due to better health outcomes, but the cost of the program would still be substantial.
The CBO anticipates that while some savings may arise from decreased medical expenses in the future, substantial financial impacts on the Medicare program would continue until at least 2044.
An important consideration is that semaglutide, an ingredient in popular drugs like Wegovy and Ozempic, is likely to be prioritized for Medicare price negotiations due to its impact on the Medicare Part D program, said Bloomberg.
However, the CBO also warned that any projections of savings are uncertain, given the rapidly changing landscape of drug research and pricing.
Harris Pushes for Expanded Medicare Coverage for Elder Care
As the analysis sparks conversations about weight-loss medication coverage, Vice President Kamala Harris has taken the opportunity to advocate for broader federal funding support for elderly Americans needing home care.
During an appearance on 'The View,' Harris shared her personal story about the challenges of caregiving, emphasizing the need to support the "sandwich generation," adults caring for both aging parents and children.
Harris's proposal includes an expansion of Medicare to cover long-term care services like in-home aides, aiming to provide greater support for aging Americans while offering assistance to family caregivers.
The Vice President highlighted that home aides can play an essential role in maintaining the dignity and autonomy of elderly people by assisting them with daily activities.
This initiative aligns with President Joe Biden's administration's broader legislative agenda, which has previously included provisions for enhanced child care and senior support under the now-stalled Build Back Better Act.
Although the act failed to pass, the administration continues to push for investment in what it calls "the care economy," said AP News.
