The Trump administration is preparing a five-year pilot program that could allow Medicare and Medicaid to cover expensive GLP-1 weight loss drugs such as Ozempic, Wegovy, Mounjaro and Zepbound. If implemented, the initiative could give millions of Americans access to treatments currently restricted by government insurance.
This experiment would mark a shift in federal health policy, aiming to evaluate whether these drugs, when paired with lifestyle coaching, can improve public health and reduce long-term costs. The project, due to begin in April 2026 for Medicaid and January 2027 for Medicare, will be managed by the Center for Medicare and Medicaid Innovation (CMMI), according to documents obtained by The Washington Post.
A Shift in Coverage for Obesity Treatment
Under current rules, Medicare covers GLP-1 drugs mainly for Type 2 diabetes, while private insurers have expanded coverage for obesity. The proposed pilot would allow voluntary participation by state Medicaid programs and Medicare Part D plans, enabling access to these drugs for “weight management” purposes.
Chiquita Brooks-LaSure, who led CMS during the Biden administration, described the plan as a “game changer” if it results in broader access to obesity treatments. “Scientists and clinicians increasingly believe that obesity is a serious health condition that should be treated accordingly,” she said, according to The Washington Post.
This experiment follows the administration’s reversal of a previous Biden-era proposal to extend coverage for weight loss drugs. While the Trump administration remains cautious about a nationwide mandate, the pilot aims to test whether targeted coverage can deliver measurable health improvements.
Balancing Costs and Access
The financial implications of this program are substantial. According to the Congressional Budget Office, covering GLP-1 drugs for obesity could cost Medicare approximately $35 billion from 2026 to 2034. The drugs, which suppress appetite and help regulate blood sugar, typically cost between $5,000 and $7,000 per year, according to David Rind of the Institute for Clinical and Economic Review.
Despite these concerns, thirteen state Medicaid programs already cover these medications. To participate in the federal pilot, plans would also need to provide patients with structured diet and exercise coaching, ensuring that drug therapy is combined with lifestyle support.
Pharmaceutical manufacturers have expressed cautious optimism. A spokesperson for Novo Nordisk, which produces Ozempic and Wegovy, stated that “comprehensive coverage through government and commercial insurance plans is critical to affordable health care and treatment options.”
The experiment could also include the upcoming GLP-1 drug Orforglipron if it gains approval in 2026. While many questions remain about cost and participation rates, the pilot represents the administration’s most significant step towards integrating weight loss drugs into federal health programs.
