HFA Addresses Proposed Changes to Coverage for Anti-Obesity Medications

The Biden administration has introduced a proposed rule to expand Medicare and Medicaid coverage for FDA-approved anti-obesity medications (AOMs) in the United States, recognizing obesity as a chronic disease requiring comprehensive treatment.

If finalized, the expanded coverage would take effect in 2026. Key coverage changes would include the following:

Medicare Part D Expansion

• Coverage for AOMs prescribed specifically to treat obesity, even in the absence of other medical conditions.

• Eligibility would apply to beneficiaries with a body mass index (BMI) of 30 or higher.

Medicaid Coverage Standardization

• State Medicaid programs would be required to cover AOMs unless they opt out.

• The coverage would reduce disparities in access to obesity treatments among low-income populations.

FDA-Approved Medications Only

• Coverage would be limited to AOMs approved by the U.S. Food and Drug Administration (FDA).

• It would exclude compounded drugs, over-the-counter supplements, or treatments not approved for obesity.

HFA Statement

The Health & Fitness Association has released the following statement in response to this proposal:

We are encouraged by the White House’s focus on tackling the growing chronic disease and obesity epidemic, a pressing health challenge for millions of Americans. Expanding Medicare and Medicaid coverage for anti-obesity medications reflects an important acknowledgment of the need for accessible prevention and treatment options. While no single solution can address the complexities of obesity, improving access to medical interventions is a critical piece of a broader strategy to support those in need.

At the same time, research consistently shows that physical activity is a cornerstone of effective and sustainable weight management and prevention against chronic disease. Beyond its role in promoting a healthy weight, physical activity improves mental health, reduces the risk of chronic diseases, and enhances overall quality of life. Unfortunately, many Americans still face barriers to accessing safe and affordable opportunities to move and exercise. Addressing these barriers must remain a priority.

We also recognize that for some individuals—particularly those with multiple comorbidities or mobility challenges—physical activity may not be a viable option. For these populations, expanding access to medical solutions is essential. However, for millions of Americans who can benefit, greater efforts to make fitness facilities and other programs more accessible are vital to fostering better health outcomes.

The Health & Fitness Association urges policymakers to take a holistic approach to obesity prevention and treatment. Pairing expanded coverage for weight-loss medications with initiatives to increase access to physical activity will empower Americans to achieve better physical and mental health and build a healthier future for all.

Regulatory Scenarios with Administration Change

Despite this proposal, President-Elect Donald Trump takes office on January 20, 2025, which could mean changes to this proposal, depending on the rule’s status and his administration’s priorities, according to Mike Goscinski, the association’s vice president of government affairs.

"As the political landscape evolves, HFA is prepared to work with the new administration to ensure that national health policies prioritize expanding access and utilization of the fitness industry," Goscinski said.

If the rule is not finalized before Trump is inaugurated, his administration could take one of the following steps:

• Freeze or withdraw the rule: Halt the proposed regulation’s progress or rescind it entirely;

• Modify or delay implementation: Adjust the rule’s provisions through additional rulemaking or postpone its implementation date; or

• Utilize the Congressional Review Act (CRA): If the rule is finalized within the last 60 legislative days of the current Congress, it could be repealed through a CRA resolution.

"If the rule is finalized before January 20, it could still be rescinded or amended," Goscinski explained. "However, this would require a new rulemaking process, including a notice-and-comment period, which could delay or change the intended policy outcomes."

Opportunities for Collaboration

Goscinski sees several opportunities for collaboration with the Trump administration, including:

• Advocate for Medicare and Medicaid to include coverage for gym memberships as a preventative health measure, building on bipartisan interest in leveraging fitness to reduce healthcare costs;

• Work to ensure that the next administration recognizes the fitness industry as a critical component of national health strategies, emphasizing prevention and wellness; and

• Highlight public comments, such as remarks from Robert F. Kennedy Jr., who Trump has nominated to be the Department of Health and Human Services secretary, about expanding Medicare and Medicaid to cover gym memberships, showcasing the broad support for integrating fitness solutions into healthcare policy.

"The Health & Fitness Association remains committed to working with all administrations to promote policies that improve public health through greater access to fitness facilities and programs," Goscinski said.

For more information on HFA’s public policy efforts, visit our online advocacy center.