Medicare has postponed a new program intended to provide weight-loss drugs like Wegovy and Zepbound to older Americans. A Centers for Medicare & Medicaid Services (CMS) spokesperson confirmed that a temporary bridge program will offer these GLP-1 medications from July 1, 2026, through December 31, 2027. This initiative allows Medicare enrollees to access these drugs at prices negotiated under former President Trump's administration. Participants will face a $50 monthly copay.
This adjustment follows significant concerns raised by multiple insurance companies regarding the voluntary BALANCE program. Insurers were hesitant to commit to the program, which aimed to bypass prohibitions on covering weight-loss treatments by integrating them into Medicare and state Medicaid plans. CVS Health and UnitedHealth cited "notable challenges and outstanding questions" regarding the original program.
While the Medicaid portion of the BALANCE program will continue, CMS's decision to launch a bridge program amid insurer uncertainty was met with support from pharmaceutical companies like Eli Lilly and Novo Nordisk. Analysts suggest the temporary extension eases immediate demand concerns but leaves long-term integration into Medicare prescription drug plans unclear. Experts anticipate that once established, such obesity benefits will be difficult to reverse.