President Donald Trump announces plan to expand access to IVF
President Donald Trump announced plans to expand access to IVF, including employer coverage options and deep discounts on fertility drugs.
President Donald Trump on Thursday, Nov. 6, announced an agreement with pharmaceutical companies Eli Lilly and Novo Nordisk that would lower the prices of popular weight-loss drugs and expand Medicare coverage of these drugs for seniors.
The negotiated agreements will enable Medicare and Medicaid coverage for Lilly’s Zepbound and Novo’s Wegovy, allowing consumers to purchase the drugs at discounted prices through the federal government’s direct-to-consumer website TrumpRx, which launches in 2026.
“Politicians have been talking about making health care more affordable for years,” Trump said at an Oval Office press conference announcing the price cuts. “But my administration is actually doing that.”
The lowest price ($149 per month) applies to unreleased oral versions of these weight loss drugs. Lilly is seeking priority review from the Food and Drug Administration for an oral drug called orforglipron.
Pharmaceutical companies will sell injectable versions of these treatments for an average of $350 a month, but the companies plan to reduce that price to $250 over the next 24 months, a government official said.
Pharmaceutical company officials said the discounts could vary depending on the dose.
The negotiated agreement will expand access to millions of Medicare beneficiaries who currently have to pay out-of-pocket for the weight-loss drugs Zepbound and Wegovy. Medicare drug plans cover Novo’s Ozempic and Lilly’s Munjaro for type 2 diabetes.
Pharmaceutical companies have agreed to sell drugs to Medicare at an average price of $245 per monthly dose. Eligible Medicare enrollees will be charged a $50 monthly copayment to obtain the weight loss drug. Medicare plans to begin covering these drugs by July 2026.
The announcement comes as political games over cost-of-living issues intensify, with Democrats making affordability a central message in off-year elections they won in landslides across the country.
The cost of health care and health insurance has long been a thorny political issue, at the heart of the debate over reopening the government during a record-long shutdown. Most Senate Democrats are refusing to vote on the Republican-backed government funding bill unless Republicans include provisions to extend pandemic-era health insurance subsidies.
Many consumers will pay higher prices for their ACA insurance plans in 2026 because Congress has not extended pandemic-era subsidies that make Affordable Care Act plans less expensive for millions of Americans.
I am on Medicare. Am I eligible for compensation?
Government officials estimate that about 1 in 10 Medicare beneficiaries could qualify for weight-loss drugs, based on height, weight and underlying health conditions.
Medicare beneficiaries with prediabetes and a body mass index (BMI) of 27 or higher can receive this drug. People with a BMI of 30 or higher and who have kidney disease, heart failure, or high blood pressure are also covered.
Also, severely obese people with a BMI of 35 or higher are eligible for Medicare for weight loss drugs.
The Trump administration has not released estimates of how much expanding Medicare coverage for these drugs would cost federal health programs. But government officials said the price tag would be offset by the improved health of Americans taking these drugs.
States that administer Medicaid programs would have the option to expand coverage of weight loss drugs to low-income households and others eligible for Medicaid. Currently, some states cover obesity drugs for Medicaid enrollees, but most do not.
In November 2024, the Biden administration drafted a rule to expand Medicare and Medicaid coverage of obesity drugs starting in 2026. At the time, Centers for Medicare and Medicaid officials estimated that anti-obesity drugs would cost Medicare and Medicaid about $40 billion over 10 years.
Do private insurance companies cover weight loss drugs?
Weight loss drugs known as glucagon-like peptide-1 drugs (GLP-1) suppress the user’s appetite, leading to weight loss.
While insurance companies often cover GLP-1 drugs when prescribed for conditions such as diabetes, heart disease and sleep apnea, more than half of employer insurance plans refuse to cover drugs to treat obesity. Mercer, a benefits consultant, said 44% of all large employers will have GLP-1 drug coverage for obesity in 2024, up from 41% in 2023.
Most working-age adults are covered by employer insurance plans, but government officials said the negotiated agreement could allow consumers to buy cheaper versions of these drugs through TrumpRx or directly from drug companies.
Sam’s Club and Costco pharmacies are currently selling Novo Nordisk’s blockbuster weight loss drug Wigovy and diabetes drug Ozempic for $499 a month.
What else is the Trump administration doing about drug prices?
President Trump has already announced deals with several drug companies to sell other drugs at discounted prices to federal health programs and TrumpRx.
The president is pressuring drug companies to lower prices to what patients are paying in other countries, a concept known as most-favored-nation pricing. On September 30, President Trump announced that he had entered into a most-favored-nation agreement with Pfizer to sell drugs more cheaply through Medicaid.
President Trump also said last month that EMD Serono, the nation’s largest maker of fertility drugs, had agreed to reduce the price of commonly used IVF drugs.
