Pharmalittle: States opting out of Medicaid obesity-drug coverage

Pharmalittle: States opting out of Medicaid obesity-drug coverage

Good morning, everyone, and welcome to another working week. We hope the weekend respite was relaxing and invigorating because that oh-too-familiar routine of meetings, deadlines, and the like has returned with a vengeance. You knew this would happen, yes? To cope, we are relying, as always, on cups of stimulation. Our choice today is tiramisu. Feel free to join us. Remember, no prescription is required. Meanwhile, here are some tidbits to help you along. Best of luck accomplishing your goals today and, of course, do keep in touch. …

President Trump’s pledge to make pricey weight loss drugs widely available for low-income Americans is not panning out as planned, Politico explains. Last year, Trump promised Medicaid would provide access to GLP-1 drugs if states signed on with his administration to negotiate prices directly with manufacturers. But only Indiana has publicly done so. Some states stopped covering the drugs for Medicaid patients who need them for weight loss. Others are considering ending coverage. States opting out of coverage cited budget constraints and concerns about the long-term financial sustainability of Trump’s model.

The Trump administration plans to use a new approach to deny Medicaid coverage of drugs for gender-affirming care, STAT tells us. The precedent it sets could also be used to avoid paying for other drugs, upending an expectation that Medicaid covers the vast majority of prescription medicines. The Centers for Medicare and Medicaid Services issued a final rule this month barring use of federal Medicaid and CHIP funding to pay for pediatric gender-affirming medications and surgery. The rule, set to go into effect Oct. 13, attracted attention because it is the latest development in the administration’s campaign to halt transgender health care for young people.

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