Medicare to Cover Weight Loss Drugs via Extended
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- The Trump administration is launching a Medicare demonstration program next month that will cover weight loss drugs for adults 65 and older for the first time, circumventing a federal law that prohibits Medicare from paying for obesity drugs.
- Medicare initially planned a three-year program called BALANCE that would have pushed private Medicare insurers to voluntarily cover the drugs, but insurers balked at participating.
- The federal government is now extending a transitional coverage program called Bridge until the end of next year rather than moving to the longer-term BALANCE model.
- The Bridge program is described as 'supposed to be temporary,' but the source notes it may be difficult to end once established.
Why it matters: The program gives roughly tens of millions of Medicare seniors access to weight loss drugs for the first time, but the 'temporary' Bridge mechanism was forced by private insurers refusing to take on the cost voluntarily — meaning the government is absorbing coverage that the market declined, with no clear off-ramp to end the spending.
