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Belt-Tightening of Medicare Can Begin with Coverage of Ozempic

In an interview this month, Health and Human Services (HHS) Secretary Robert F. Kennedy, Jr., appeared open to the idea of Medicare covering drugs like Ozempic and Wegovy for beneficiaries with obesity.

"Ideally, over the long term, we’d like to see . . . those drugs available for people after they try other interventions," he said.

Delaying coverage of these breakthrough weight-loss medications is not the right approach. America's epidemic of obesity poses an urgent threat not just to public health but to our health system and long-term prosperity.

This new generation of weight-loss medicines provides an effective and relatively economical strategy for getting this health crisis under control.

Secretary Kennedy's remark came just days after the Trump administration announced it would abandon a Biden-era proposal to cover GLP-1 agonists like Ozempic and Wegovy for people with obesity through Medicare Part D and Medicare Advantage.

Should the administration move forward with that decision, these medicines would only be available through Medicare for conditions such as diabetes and heart disease.

On the surface, paying for GLP-1 agonists for Medicare beneficiaries with obesity might seem expensive.

According to the Congressional Budget Office (CBO) , covering all anti-obesity medications — including GLP-1 agonists — through Medicare would cost the federal government $35 billion between 2026 and 2034.

But focusing solely on that cost obscures the value these drugs could provide.

Consider the sheer size of the obesity crisis.

By the Centers for Disease Control and Prevention's (CDC's) latest estimate, over four in ten Americans are obese.

Obesity is a major cause of any number of serious chronic diseases, including heart disease, diabetes, stroke, osteoarthritis, and certain cancers.

As a result, obesity costs America's health system a whopping $173 billion a year.

Reducing the incidence of obesity would take a significant bite out of that figure.

And by all accounts, GLP-1s are proving to be among the most effective ways to do so.

One placebo-controlled trial published in the leading British medical journal The Lancet found that semaglutide — the active ingredient in Ozempic and Wegovy — resulted in an average weight loss of 9.6% over 68 weeks in obese patients.

In a separate study, published in the journal Obesity, one-third of participants lost 5% of their weight or more after 72 weeks of treatment, without any behavioral intervention.

Researchers at the University of Southern California's Schaeffer Center for Health Policy and Economics estimate that, by covering weight loss therapies, Medicare could save between $175 billion to $245 billion in the first decade.

It's not hard to see why.

Lower obesity rates among Medicare beneficiaries would result in fewer emergency-room visits, hospital admissions, surgery, and other costly medical procedures and services.

As the Schaeffer Center's research notes, "Over 60% of these savings would accrue to Medicare Part A by reducing hospital inpatient care demands and demand for skilled nursing care."

Improvements to patient quality of life, in addition to other social benefits from the policy, would generate the equivalent of $1 trillion in the first 10 years, the authors estimate.

Seen from this perspective, GLP-1 agonists aren't just a powerful treatment for Americans with obesity. They'd deliver significant financial returns to our health system.

Payers including Medicare would be wise to cover them without restriction.

Sally C. Pipes is President, CEO, and Thomas W. Smith Fellow in Health Care Policy at the Pacific Research Institute. Her latest book is "The World's Medicine Chest: How America Achieved Pharmaceutical Supremacy -- and How to Keep It" (Encounter 2025). Follow her on X @sallypipes. Read Sally Pipes' Reports — More Here.