The House Ways and Means Committee on Thursday cleared a bill that would direct Medicare to cover obesity treatments — but only for a small sliver of beneficiaries.
The committee voted 36-4 to pass an amended version of the Treat and Reduce Obesity Act, which directs Medicare to cover obesity treatments strictly for new enrollees whose insurance previously covered the medication for at least a year before they signed up for Medicare. The vote marks a step forward in expanding insurance coverage of obesity treatments, but falls short of an earlier version of the bill that would’ve ensured more widespread coverage of the drugs under Medicare.
Rep. Brad Wenstrup (R-OH), lead sponsor on the bill, said he hopes it will pave the way for widespread Medicare coverage of obesity medications down the line.
“I hope that over time, with the use of these medications, we’ll be able to recognize the actual savings that come with greater health,” Wenstrup said. “I’m proud that the bill before us addresses this issue by providing coverage to seniors who are aging into Medicare, so they don’t lose access to an effective therapy, simply because of an outdated statute.”
Medicare is currently banned from covering obesity treatments, per a 2003 law that was passed when there were concerns about the obesity treatments available at the time. The bill was first introduced back in 2012 and has since been reintroduced during each session of Congress.
But the landscape has shifted since the bill was first floated with the emergence of blockbuster GLP-1 drugs that are prescribed for both diabetes and obesity. GLP-1 manufacturers Eli Lilly and Novo Nordisk have both amped up their lobbying efforts on the bill in the past few months, according to federal lobbying disclosures.
“I would say to Big Pharma, the demand for these drugs is there, and you would still get a phenomenal return on your investment for you to lower your prices,” said Rep. Gwen Moore (D-WI), a lead on the bill.
Some Democrats on the committee took issue that coverage hinges on patients already having comprehensive healthcare coverage before joining Medicare. Rep. Lloyd Doggett (D-TX) pointed out that the majority of both ACA plans and employer-offered health plans don’t cover obesity drugs.
“I’m concerned that this bill really creates and exacerbates more public health problems than it resolves,” he said.