Older Americans Say Medicare Should Cover Obesity Medicines

Yesterday in JAMA Network Open, researchers from the University of Michigan published a finding that older Americans say Medicare should indeed cover obesity medicines. Authors Lauren Oshman and colleagues present straightforward conclusions:

“In this survey study of older US adults, most participants agreed that Medicare should cover weight management medications and more than half of those with BMI of 30 or greater were interested in using them. These results should inform decisions to include weight management medications in the Medicare and commercial insurance programs, as well as utilization policies to control health care costs.”

Yes, older Americans are raising their hands. They favor a new rule at CMS that would have Medicare cover the cost of obesity medicines.

Views

Oshman et al analyzed data from 2,657 U.S. adults between the ages of 50 and 80 years. These data come from the 2023 National Poll on Healthy Aging. Respondents answered questions about awareness, beliefs, and use of obesity medicines. They also provided views on insurance coverage and barriers to their use. A striking majority – 83% of respondents – said that health insurance should cover these medicines. A similar number (75%) said Medicare specifically should cover them.

Resistance of the Sick Care Industry

Health professionals and advocates of all political persuasions recognize that American healthcare systems focus more on sickcare than healthcare. This is the foundation of the appeal RFK Jr. has found for his rallying cry to “make America healthy again.”

But sickcare is very profitable. Much of the revenue health insurance plans generate is for treating the chronic diseases that result from denying people care for obesity. Diabetes, arthritis, cancer, heart, liver, and kidney disease are veritable cash cows for giant health insurers like Cigna.

This is why, frankly, we find no surprise in the fact that those insurers really don’t want to see coverage coming for obesity under Medicare or anything else. It will stunt the growth of the sickcare market. David Cordani is the CEO of Cigna. At a recent forum, he was blunt in saying he doesn’t like even discussing the possibility:

“We’re the only country having this debate around covering [these medicines] for weight management. If individuals in other countries want it for weight management, that’s an out-of-pocket individual decision.”

Circular Reasoning

Of course, the resistance of a sickcare industry profiting from obesity-related chronic disease is a subject that stays largely out of view. More often we hear rationalizations about saving money by excluding obesity medicines so that health plans can afford to treat all the chronic disease that the high prevalence of untreated obesity has given us.

This is a trap of circular reasoning we must escape. People who live with obesity already know it.

Click here for the new study by Oshman et al and here for background on a similar study. For further perspective on the issues of sickcare systems, click here.

Hand, painting by Kuzma Petrov-Vodkin / WikiArt

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March 27, 2025