The Biden administration on Tuesday issued sweeping health care proposals that would see Medicare plans greatly expand access to blockbuster GLP-1 weight-loss drugs, bar insurers from skipping out on paying certain claims that were granted prior authorization, and reinforce guardrails on the use of AI.
The proposals fit into the administration’s existing aims to improve and protect access to care in Medicare and Medicaid programs. But, the future of the proposals is uncertain, as it will be up to the Trump administration to finalize the policies.
Anti-obesity drugs
The flashiest of the proposals is to reinterpret existing law in such a way as to allow Medicare and Medicaid coverage of anti-obesity drugs—particularly the extremely popular and pricy GLP-1 drugs Wegovy and Zepbound. Existing policy excludes coverage of drugs used for “weight loss” or “weight gain.”
