{"id":983,"date":"2025-04-10T22:12:24","date_gmt":"2025-04-10T22:12:24","guid":{"rendered":"http:\/\/thenewamore.com\/?p=983"},"modified":"2025-04-11T14:27:09","modified_gmt":"2025-04-11T14:27:09","slug":"rfk-jr-considering-framework-for-medicaid-medicare-coverage-of-glp-1s","status":"publish","type":"post","link":"http:\/\/thenewamore.com\/index.php\/2025\/04\/10\/rfk-jr-considering-framework-for-medicaid-medicare-coverage-of-glp-1s\/","title":{"rendered":"RFK Jr. considering 'framework' for Medicaid, Medicare coverage of GLP-1s"},"content":{"rendered":"
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Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. said he is considering a \u201cregulatory framework\u201d for Medicare and Medicaid to cover GLP-1 medications to treat obesity.<\/p>\n

Kennedy said in a CBS News interview<\/a> that aired Wednesday the high cost of the medication is the biggest hurdle to coverage, but he said he\u2019s considering a proposal for Medicaid and Medicare to cover the drug once patients have established they\u2019ve exhausted other options.<\/p>\n

\u201cIdeally, over the long term, we’d like to see \u2026 those drugs available for people after they try other interventions,\u201d Kennedy said.<\/p>\n

\u201cGlucose monitors, for example, which are very, very effective and only cost $80 a month, and they’ve been shown to be extraordinarily effective in helping people lose weight and avoid diabetes,\u201d he continued. \u201cHealth regimens \u2014 including, particularly, change in diet, but also exercise.\u201d<\/p>\n

CBS News chief medical correspondent Jon LaPook noted those methods have “been tried for half a century.” Kennedy responded by emphasizing the availability of new technology to track individual progress.<\/p>\n

\u201cNow, we have ways of monitoring it, so that people can monitor themselves, and they can show that they’ve done these interventions,\u201d Kennedy said.<\/p>\n

\u201cAnd if they don’t work, then you would be entitled to the drug,\u201d Kennedy added, noting, \u201cthat\u2019s the framework that we\u2019re now debating.\u201d<\/p>\n

In November, the Biden administration proposed a new rule<\/a> that would allow drugs like Wegovy and Zepbound to be covered by Medicare and Medicaid, expanding access for roughly 3.4 million Medicare users and about 4 million Medicaid enrollees.<\/p>\n

But the Centers for Medicare and Medicaid Services said in a notice last Friday that it would not be finalizing this proposed rule, providing no further details.<\/p>\n

Medicare does cover GLP-1 drugs when prescribed for conditions like diabetes and heart disease, but legislation from 2003 prohibits Medicare from covering drugs solely for weight loss. <\/p>\n

Under the Biden administration\u2019s proposal, older and\/or low-income Americans with a body mass index of 30 or higher would have qualified for coverage for the drugs.<\/p>\n

Kennedy has criticized GLP-1 medications like Ozempic in the past, claiming in interviews that these drugs are being pushed onto Americans by foreign companies who don\u2019t sell the same product in their home countries. Kennedy has instead focused on lifestyle changes for combating obesity, though he told CNBC last year<\/a> GLP-1s \u201chave a place\u201d in treating obesity.<\/p>\n

The HHS secretary this week stressed cost as the biggest barrier to getting Medicaid and Medicare coverage, calling GLP-1s \u201cextraordinary drugs.\u201d<\/p>\n

\u201cI think everybody would like to make those drugs available to everybody under Medicaid and Medicare, but the impact on our medical costs would increase dramatically,\u201d Kennedy told CBS News. \u201cOne of the estimates I saw is that the average employer in this country would end up paying double what they’re paying now for health care costs for their workers.\u201d<\/p>\n

Kennedy noted the GLP-1 drugs are a fraction of the cost in other countries compared to the U.S., adding, \u201cPresident Trump has ordered us to get, to bring it down to, you know, something around European pricing.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. said he is considering a \u201cregulatory framework\u201d for Medicare and Medicaid to cover GLP-1 medications to...<\/p>\n","protected":false},"author":1,"featured_media":985,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[14],"tags":[],"_links":{"self":[{"href":"http:\/\/thenewamore.com\/index.php\/wp-json\/wp\/v2\/posts\/983"}],"collection":[{"href":"http:\/\/thenewamore.com\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/thenewamore.com\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/thenewamore.com\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/thenewamore.com\/index.php\/wp-json\/wp\/v2\/comments?post=983"}],"version-history":[{"count":1,"href":"http:\/\/thenewamore.com\/index.php\/wp-json\/wp\/v2\/posts\/983\/revisions"}],"predecessor-version":[{"id":984,"href":"http:\/\/thenewamore.com\/index.php\/wp-json\/wp\/v2\/posts\/983\/revisions\/984"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/thenewamore.com\/index.php\/wp-json\/wp\/v2\/media\/985"}],"wp:attachment":[{"href":"http:\/\/thenewamore.com\/index.php\/wp-json\/wp\/v2\/media?parent=983"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/thenewamore.com\/index.php\/wp-json\/wp\/v2\/categories?post=983"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/thenewamore.com\/index.php\/wp-json\/wp\/v2\/tags?post=983"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}