This bill would require Medicare Part D prescription drug plans to cover weight loss medications, specifically GLP-1 receptor agonist drugs like those used for obesity treatment, starting in 2026. The coverage would apply to "dual eligible" individuals—people enrolled in both Medicare and Medicaid—who have obesity or are overweight. The legislation targets this population because dual eligible beneficiaries typically have very limited incomes (87 percent earn less than $20,000 annually) and currently face high out-of-pocket costs for these medications, which can run $900 to $1,350 per month without coverage. Congress notes that obesity affects nearly half of Medicare beneficiaries and is the second leading cause of death in the United States, costing the healthcare system $173 billion annually. By requiring coverage under Medicare Part D, the bill aims to make these weight loss medications more affordable and accessible to lower-income seniors and disabled individuals who qualify for both programs.
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