Medicare Mandates Part D Coverage for Obesity Drugs, Expands Access to Weight Management Therapy

The newly introduced Treat and Reduce Obesity Act of 2025 aims to tackle the soaring health and financial costs of obesity, especially among older Americans, by making two big changes to Medicare. First, it expands who can provide intensive behavioral therapy for obesity. Second, and perhaps more significantly, it forces Medicare Part D plans to start covering certain weight loss and anti-obesity medications starting two years after the bill becomes law (Sec. 4).

Opening Up the Therapy Gate

Right now, Medicare coverage for intensive behavioral therapy (IBT) for obesity is pretty limited in who can deliver it. This bill throws open that door (Sec. 3). Instead of just qualified primary care doctors, the Secretary of HHS can now approve coverage when IBT is provided by a much wider range of professionals: think physician assistants (PAs), nurse practitioners (NPs), clinical psychologists, and registered dietitians/nutrition professionals. This is a huge deal for access. If you live in a rural area where primary care doctors are scarce, you might now be able to get this covered therapy from a local NP or dietitian. The catch? The therapy still requires a referral from a physician or primary care practitioner, and the provider has to coordinate and communicate the treatment plan back to that referring doctor. This ensures oversight, but it also adds a layer of coordination that could become a bottleneck if not managed well.

Part D’s Mandatory New Line Item

The most expensive provision for Medicare Part D plans is the requirement to cover anti-obesity medications (Sec. 4). Currently, Medicare Part D explicitly excludes drugs used solely for weight loss. This bill carves out an exception: if a Part D enrollee is seeking treatment for obesity or is overweight and has at least one related health issue (a comorbidity), the plan must cover the drug. This is a massive win for beneficiaries who have struggled to afford these often expensive medications out-of-pocket, especially those managing conditions like high blood pressure or diabetes alongside their weight. For the pharmaceutical industry, this opens up the huge Medicare market for their products.

However, this mandatory coverage comes with a price tag. Part D plans—the private insurers who administer the drug benefit—will see their costs jump significantly. While this is great news for the patient who needs the drug, it means higher costs for the plans, which could ultimately translate into higher premiums or increased costs for the Medicare system overall. It’s a classic trade-off: better coverage and access versus higher financial expenditures.

The Long-Term Check-In

To ensure all these changes don't just happen in a vacuum, the bill requires the Secretary of HHS to report back to Congress, starting one year after enactment and then every two years after that (Sec. 5). These reports must detail how the new rules are being implemented and suggest ways federal agencies can better coordinate research and prevention efforts. For the busy taxpayer, this is the accountability check—it means the government has to show its work and prove that this expanded coverage is actually benefiting public health and not just adding bureaucracy or cost without results. It’s a necessary step to track whether these significant policy changes are moving the needle on the nation’s obesity crisis.