Three U.S. states recorded an adult obesity rate of 40% or higher in 2022. Data Source: Centres for Disease Control and Prevention. (Graphic by Visual Capitalist via Getty Images)
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As the Trump Administration and its DOGE team aggressively—and rightfully—ferret out ways to reduce wasteful and abusive government spending, they’ll find a mother lode of such outlays throughout our federal health programs, especially in Medicare and Medicaid. They range from massive overcharges by corporate health insurers to the diversion of billions of dollars from Medicare to pay for ex-President Joe Biden’s costly and utterly unrelated green energy boondoggles.
But, as odd as it may sound, there’s one specific area with respect to Medicare and Medicaid where we should spend more, not less. Specifically, we need to expand coverage of modern weight-loss medications. Doing so would not only help produce healthier outcomes and save patients’ lives but also save taxpayers trillions of dollars in the long run.
Bad news first. A 2024 congressional committee report estimated that, if left unchecked, obesity in the U.S. will be responsible for between $8.2 trillion to $9.1 trillion in additional medical expenditures over the next ten years. All told, the obesity epidemic is on track to diminish the size of the U.S. economy by as much as $14 trillion and to reduce federal tax revenues by around $2.5 trillion. This not only impacts our fellow citizens but also affects even our national security and military readiness. Nearly two-thirds of active troops are now classified as overweight or obese.
In happy contrast, a study from the University of Southern California’s Leonard D. Schaeffer Center estimated the vast potential savings that could be generated by Medicare and Medicaid coverage of anti-obesity medications (AOMs). Researchers estimated that Medicare coverage of weight-loss therapies could save as much as $1 trillion in medical costs over ten years. Medicaid would increase this exponentially, considering the number of people who could become healthier and more productive throughout their adult lives. These savings are possible because obesity is directly connected to some of the most common and expensive-to-treat illnesses: heart disease, type 2 diabetes, arthritis and certain cancers.
In 2019–20 heart disease, the number one killer in America for both men and women, cost the nation over $250 billion in medical costs and lost productivity. One study on AOM use by patients with heart or artery disease found that the average annual per-individual healthcare cost declined by $7,502. Impressively, this was after factoring in the cost of these medications. Just reducing the risk of heart disease by treating obesity would not only improve health outcomes but also cut healthcare spending dramatically, much of which is born by Medicare and Medicaid.
The Centers for Medicare & Medicaid Services (CMS)—likely soon to be led by Dr. Mehmet Oz, a long-time champion of AOMs—previously put forth a proposal that has bipartisan support to expand access to prescribed obesity medications. The Trump Administration would be wise to embrace this sensible, constructive policy change as part of its Make America Healthy Again agenda.
The current failure of Medicare to cover AOMs is based on outdated perceptions of older weight-loss drugs regarding safety issues and their use for cosmetic reasons. Today’s AOMs are medications that provide real benefits to patients and payers. Ironically, Medicare provides coverage for certain types of weight-gain medicines when used for noncosmetic purposes but doesn’t give the same support for AOMs that can successfully treat obesity while simultaneously addressing the serious, chronic diseases that accompany it.
Medicare and Medicaid coverage for AOMs is a necessary and cost-saving approach to an epidemic of our own making. AOMs aren’t a silver bullet but, when matched with the adoption of a healthier lifestyle and diet, are a critically needed tool to address a serious problem impacting families, seniors, workers and employers. And, in doing so, AOMs will seriously assist combatting out-of-control and wasteful government healthcare spending down the road.
If the Trump Administration chooses to move forward with the CMS proposal, it would not only help Make America Healthy Again but also help Make America Great Again economically.
