Medicare Overhaul: New Bill Expands Access to Weight Management Therapy and Mandates Coverage for Obesity Drugs

The Treat and Reduce Obesity Act of 2025 is hitting the reset button on how Medicare handles obesity, a condition the bill notes is linked to 300,000 deaths annually and costs the system billions. Essentially, this legislation makes two huge changes: it expands who can provide intensive behavioral therapy for obesity and, crucially, it forces Medicare Part D to start covering weight management medications.

The Therapy Access Expansion: More Cooks in the Kitchen

Right now, if you’re a Medicare beneficiary needing intensive behavioral therapy for obesity, you generally have to get it from a primary care doctor. This bill (Sec. 3) tears down that wall. It gives the Secretary of Health and Human Services the authority to expand coverage to a much wider array of professionals, including physician assistants, nurse practitioners, clinical nurse specialists, clinical psychologists, and—a big one—registered dietitians or nutrition professionals.

What does this mean for real people? If you live in a rural area or a place where primary care appointments are booked solid for months, this is a game-changer. It means you could potentially get the necessary counseling from a dietitian or a nurse practitioner much sooner, improving access and convenience. However, there’s a catch: these new providers can only offer the therapy after a primary care doctor refers you, and they must coordinate and share treatment plans with that referring doctor. This setup aims for better care coordination, but it also adds administrative steps for the primary care physician, who now has to manage more referrals.

Part D Gets a Weight Loss Mandate

This is the provision that will likely grab the most attention: Medicare Part D must now cover obesity medication (Sec. 4). Currently, Part D explicitly excludes drugs used for weight loss. This bill removes that exclusion for drugs used to treat obesity or weight loss management, provided the patient is overweight and also has at least one related health issue, or “comorbidity” (like high blood pressure or diabetes).

If you’re a Medicare beneficiary struggling with weight-related chronic conditions, this is massive. It shifts life-changing, often expensive, medications from being an out-of-pocket expense to a covered benefit. Think about the person juggling insulin costs and blood pressure meds; adding a covered weight management drug could stabilize their health and potentially reduce the long-term need for other expensive treatments. Keep in mind, though, this change doesn't kick in until two years after the bill becomes law, so don't expect immediate coverage.

The Fine Print: Where the Details Matter

While the bill focuses on expanding access, it leaves a few important details to the Secretary of HHS. For instance, the new therapy providers must use “evidence-based methods,” but the bill doesn't specify what those are, meaning the Secretary will have to define the quality standards. Also, the Secretary has the authority to approve “any other location” for therapy delivery beyond standard offices or hospitals. While this could potentially allow for convenient community-based programs, it’s a vague authority that needs clear oversight to ensure patient privacy and quality are maintained.

Overall, this bill is a major step toward treating obesity as the serious chronic condition it is, rather than a lifestyle choice. By expanding the workforce that can provide counseling and ensuring drug coverage, the Treat and Reduce Obesity Act of 2025 aims to improve health outcomes for millions of older Americans, hopefully reducing those massive $500 billion-plus annual obesity costs cited in the bill's findings.