Trump Rejects Plan to Cover Obesity Drugs Under Medicare: What It Means for America.
On April 4, 2025, the Trump administration made headlines by rejecting a Biden-era proposal to expand Medicare and Medicaid coverage to include anti-obesity medications like Wegovy and Zepbound. This decision, announced just months into President Donald Trump’s second term as the 47th President, marks a significant shift in federal health policy and has sparked intense debate across the political and medical spectrum. With obesity affecting over 42% of Americans—a figure unchanged since 2020—the move has raised questions about affordability, access, and the government’s role in tackling a public health crisis. As of today, April 7, 2025, the ripple effects are already being felt.
The rejected plan, initially proposed by the Biden administration in late 2024, aimed to classify obesity as a chronic condition eligible for drug coverage under Medicare Part D and Medicaid, a departure from its current status as a lifestyle issue. Drugs like Wegovy (semaglutide) and Zepbound (tirzepatide), which can cost over $1,000 monthly without insurance, have shown remarkable efficacy—patients lose 15-20% of body weight on average—prompting calls for broader access. The Biden proposal, backed by groups like the Obesity Action Coalition, sought to ease the financial burden for the 72 million Medicare and Medicaid enrollees eligible due to obesity-related comorbidities like diabetes. Trump’s team, however, axed it, citing fiscal responsibility and skepticism about pharmaceutical profiteering.
Why the rejection? Trump administration officials, including Health and Human Services Secretary Robert F. Kennedy Jr., argue that covering these drugs would balloon federal spending—estimates pegged the cost at $35 billion over a decade—while benefiting drugmakers like Novo Nordisk and Eli Lilly, whose stock prices dipped 3% and 2%, respectively, after the news. Kennedy, a vocal critic of Big Pharma, called it a “handout to an industry already swimming in profits,” pointing to Medicare’s $180 billion annual drug spend. The administration instead touts lifestyle interventions—diet and exercise—backed by Trump’s broader “Make America Healthy Again” push, though critics note these alternatives lack the immediate impact of medications for severe cases.
The decision isn’t without precedent or support. During Trump’s first term, his administration similarly resisted expanding Medicare drug coverage, prioritizing private sector solutions and deregulation. Posts on X reflect a split sentiment: some users cheer the move as a stand against “Big Pharma greed,” while others lament it as a blow to vulnerable populations—seniors and low-income Americans—who can’t afford these drugs out-of-pocket. Obesity specialists, like Dr. Fatima Cody Stanford of Harvard, warn that without coverage, disparities will widen, as only wealthier patients can access treatments hailed as game-changers since their FDA approval for weight loss in 2021 and 2022.
Democrats and patient advocates are pushing back hard. Senate Minority Leader Chuck Schumer (D-N.Y.) called the rejection “short-sighted and cruel,” vowing to fight for coverage in the next budget battle. The American Medical Association, representing 250,000 physicians, issued a statement urging reconsideration, citing obesity’s link to heart disease, stroke, and cancer—conditions costing Medicare $200 billion yearly. Meanwhile, the rejection aligns with Trump’s broader agenda to rollback Biden policies, from healthcare to climate, as he leans on advisors like Elon Musk and Vivek Ramaswamy to slash federal spending—evident in the Department of Government Efficiency’s early moves.
The fallout is already tangible. Drugmakers are pivoting to private insurance lobbying, while states like North Carolina, which expanded Medicaid under Biden, may explore covering these drugs independently—a patchwork approach experts say could deepen regional inequities. Patients, meanwhile, face a stark reality: a 68-year-old Medicare recipient with obesity and diabetes told NPR she’ll “just have to ration food harder” without Wegovy. The decision also complicates Trump’s promise to improve American health, as obesity rates, unchanged despite his first-term efforts, remain a stubborn challenge amid rising fast-food consumption and sedentary lifestyles.
What’s next? With Republicans controlling Congress, reversing this decision legislatively seems unlikely before the 2026 midterms. However, pressure from voters—77 million of whom backed Trump in 2024—could shift the calculus if public outcry grows. For now, the rejection of obesity drug coverage underscores a defining tension in Trump’s second term: balancing fiscal conservatism with tangible health outcomes. As the debate rages on, one thing is clear: America’s obesity crisis isn’t going away, and neither is the fight over how to address it.
