Medicare Access At-a-Glance

The Trump Administration Must Act Now to Expand Access to Obesity Treatments

Action Will Support Millions of Americans With Obesity and Make America Healthier!

By 2030, experts estimate that nearly half of all American adults will be living with obesity. Medicare coverage of safe, effective, and life-saving obesity medications would make a significant impact to those living with obesity. The Trump Administration must act now to find innovative and winning solutions that ensure patient access to obesity medications and change the course of this chronic disease in the United States.

How the Trump Administration Can Improve Access to Obesity Care

THE SITUATION: Obesity is a complex, multifactorial chronic condition that impacts millions of Americans. Patients living with obesity are at a high risk of developing other conditions such as heart disease, stroke, type 2 diabetes, and certain cancers, which are leading causes of preventable deaths in the U.S. We must ensure that safe and effective treatments for obesity are accessible for those who need them most.

THE PROBLEM: While the majority of Medicare beneficiaries have obesity or are overweight, the Centers for Medicare & Medicaid Services (CMS) still prohibits prescription drug coverage of obesity medications. CMS cites an outdated federal statute that excludes agents used for weight loss or weight gain. Americans with obesity shouldn’t face barriers to innovative medications due to bureaucratic constraints.

THE SOLUTION: The Trump Administration has the power and vision to meet the urgency of this moment in the epidemic and change the course of this chronic disease. Working hand-in-hand with stakeholders, the Trump Administration can implement innovative solutions that ensure access to treatments and care for the millions of Americans living with obesity.

By the Numbers: The Impact of Obesity

In nearly half of U.S. states, more than one in three adults has obesity. This is an increase from 2013, where no state had a prevalence over 35%. The 23 states with the highest rates are: Alabama, Alaska, Arkansas, Delaware, Georgia, Illinois, Indiana, Iowa, Kansas, Louisiana, Michigan, Mississippi, Missouri, Nebraska, New Mexico, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Tennessee, West Virginia, and Wisconsin.

Over two-thirds of Medicare beneficiaries are affected by obesity or are overweight. In 2021, 34% of Medicare beneficiaries had obesity and another 35% were considered overweight.

The prevalence of obesity in rural America is up to six times higher. While only 19% of the U.S. population lives in rural areas, they face an outsized burden of obesity.

Addressing obesity comprehensively and proactively through medications and lifestyle modifications can significantly reduce other healthcare costs, as demonstrated by a Veterans Health Administration (VA) study. Obesity costs the US healthcare system almost $173 billion per year. American adults living with obesity experience higher medical care costs by $2,505/year.

Advocacy Groups Call for Improved Access to Care

In a letter to HHS Secretary Robert F. Kennedy, Jr. and CMS Administrator Mehmet Oz, 81 groups, who together represent American patients, healthcare providers, caregivers, and older Americans, wrote to encourage the Trump Administration to work collaboratively to empower patient choices and provider autonomy to address the obesity epidemic and make Americans healthier.

In the letter, they write:

“The Trump Administration can work with stakeholders to find innovative and winning solutions that ensure patient access to the most effective tools to treat obesity. As it stands, outdated federal policies stand in the way of significant scientific developments that have been made to treat and manage obesity. In fact, many federal agencies and states have joined the American Medical Association (AMA) in recognizing obesity as a complex disease and providing coverage for comprehensive obesity care and treatments…By working together, we can meet the moment to Make America Healthy Again and leverage innovation to win the fight against obesity.”

 

A WIN FOR ALL: Make Americans Healthier and Expand Access to Obesity Medications