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Miami lawmaker pushes for Medicaid, Medicare to cover anti-obesity medicine

Miami lawmaker pushes for Medicaid, Medicare to cover anti-obesity medicine

Miami Herald07-03-2025
For a state of over 23 million people, approximately 40% of the population has one thing in common — they are either Medicare or Medicaid beneficiaries. Across the Sunshine State, just shy of nine million people utilize government health insurance programs.
With many individuals in Florida relying on these programs, ensuring they are as comprehensive as possible is key to improving health.
For many beneficiaries of these programs, one of the biggest health issues they face is obesity and its various co-morbidities. But just 10% of people with obesity receive any treatment for the disease.
In the Florida Legislature, which went into session this week, we're looking to change that. I've introduced legislation, Senate Bill 648, that would expand Medicaid treatment options for obesity, including covering the cost of the use of Food and Drug Administration (FDA) approved anti-obesity medications, known as AOMs.
Now, I hope the federal government follows our lead. President Donald Trump has long fought for commonsense healthcare reform. Fortunately, he has a chance to deliver on it. He is reviewing a rule from the Centers for Medicare & Medicaid Services (CMS) which establishes or modifies what Medicare and Medicaid will cover.
Only by finalizing this proposed CMS rule and expanding AOM can their full potential be realized in Florida and across the country. It's necessary that Trump finalize it.
Obesity is the nation's second leading cause of death and raises an individual's mortality rate from anywhere from 22% to 91%. Not to mention, it's a significant risk factor for the leading cause of death: heart disease. Beyond that, it's connected to over 200 other serious chronic diseases ranging from diabetes to 13 of the most prevalent cancers to arthritis.
All told, the impact of obesity on the human body is severe. For years, lifestyle changes, primarily diet and exercise, have been the primary treatment option for obesity. But it's clear that this alone is not the most effective treatment available.
For patients who adopt lifestyle changes and nothing else, more than 95% of weight lost is regained within five years. That's where AOMs come into play.
AOMs have been proven to be a highly effective tool in treating obesity. Over the last several years, a sizable body of research has shown their benefits, including reduced blood pressure, reduced sleep apnea, improved glycemic health and significant, sustained weight loss. They provide a pathway to weight loss that, in turn, reduces the risk of obesity-related complications.
For our state's seniors, reducing obesity can mean a lessened risk of falls, better mental health and a lower chance of nursing home admission, all of which serve to enhance independence. But right now, far too few individuals have access to them. Of the 10% of people who receive any medical help for obesity, a minuscule 2% subset take AOMs.
Annually, across the entire U.S. public and private healthcare system, hundreds of billions of dollars are spent on obesity and related illnesses. Looking at the Medicare and Medicaid programs alone, that figure is beginning to encroach on $100 billion a year.
The link between obesity and other chronic diseases is clear and lead down the same path — more hospitalizations, more deaths and higher annual medical costs.
On the flip side, the broader use of AOMs, particularly among Medicare and Medicaid recipients, has a clear line to fewer medical costs in treating obesity and related conditions.
The more effective treatment of obesity through Medicare and Medicaid could lead to net savings of over $700 billion over the next 30 years.
Obesity is one of our nation's biggest public health crises, and AOMs are a pivotal innovation in the healthcare space as we look to solve it.
Only by finalizing this proposed CMS rule and expanding AOM coverage in Medicare and Medicaid can their full potential be realized.
Ana Maria Rodriguez is a Republican state senator representing District 40, which includes parts of southern Miami-Dade and Monroe counties.
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