(The Center Square) – As the old saying goes, “an ounce of prevention is worth a pound of cure,” and in my decades of experience in healthcare that absolutely rings true. Thanks to some promising new medical advances, we have a real opportunity to bring prevention and harm reduction to the fight against obesity at scale.
There is currently a proposed Center for Medicare and Medicaid Services (CMS) draft rule that would provide for coverage for Anti-Obesity Medications (AOMs) to beneficiaries. These medications, known as GLP-1s and commonly known by brand names such as Mounjaro and Wegovy, have been shown to dramatically reduce obesity in patients who have access to them. Unfortunately, access is often limited by authorization and cost, and not everyone who needs these medications is able to obtain them.
In the U.S. more than 40% of adults are dealing with obesity, which means that there are more than 100 million adults who are obese, and more than 22 million who meet the definition of “severe obesity.” Worse yet, the phenomenon has been increasing dramatically in recent years. In 2000, the adult obesity rate was only 30%. Even more alarmingly, the rate of adults with severe obesity has nearly doubled in that time, going from 4.7% to 9.2%.
Fortunately, Pennsylvania is doing somewhat better than the national figures, with only 33% of adult Pennsylvanians meeting the definition of obesity, but that still means that millions of Pennsylvanians are susceptible to the negative health outcomes of obesity, and adopting this rule for Medicare and Medicaid would bring vital new treatment options to the nearly 6 million Pennsylvanians who are enrolled in one of the programs, and since Medicaid is partially funded by state tax dollars, this move would also benefit all Pennsylvania taxpayers.
Many adults with obesity are also dealing with one or more related chronic ailments. In the U.S. 58% of adults with obesity also have high blood pressure, and 23% have diabetes. Not only does obesity lead to worse health outcomes for those affected, the obesity epidemic harms society at large by causing health care spending to skyrocket.
The average annual medical costs in 2019 was nearly $2,000 higher for adults with obesity, and more than $3,000 higher for adults with severe obesity, leading to an additional $173 billion in medical expenditures that could have been directed elsewhere. According to CMS, health care spending in the U.S. reached nearly $5 trillion in 2023, which accounts for 17.6% of the country’s Gross Domestic Product (GDP).
These numbers paint a troubling picture of the present, and predict an even more dire future, but the good news is that we have a historic opportunity to reverse course. If the Trump administration moves to finalize this rule, the benefits would be dramatic.
There is even new research from Penn State indicating that these drugs could help combat the opioid epidemic. Researchers like Dr. Patricia Grigson and Dr. Scott Bunce recently found that these medications reduced addiction-like behavior for heroin and fentanyl in rodent trials, as well as in preclinical human trials. The mere fact that these medications could one day not only treat obesity, but opioid addiction is revolutionary—and this research is taking place right here in Pennsylvania.
As the Trump administration looks to “Make America Healthy Again,” our members of Congress like Reps. Fitzpatrick, Joyce, and Kelly are being presented with a prime opportunity to do just that. They can demonstrate their leadership and willingness to eliminate access barriers for Medicare beneficiaries by supporting the extension of the draft CMS rule. Together, they can help make good on President Trump’s promise to forge a healthier path for Pennsylvanians and our nation.
