Supplies of high-demand obesity treatments are improving, but that doesn’t mean it’s easier to get them.

Many employers and insurers are scaling back coverage of Wegovy and Zepbound and a key government program, Medicare, doesn’t cover the drugs for obesity. Meanwhile, some big employers are adding coverage, but their commitment isn’t guaranteed.

Treatment prices that can top hundreds of dollars monthly even after discounts make it hard for many people to afford these drugs on their own. That can make the life-changing weight loss that patients seek dependent on the coverage they have and how long it lasts.

Coverage complications are not unusual in the U.S. health care system. But the challenge is magnified for these obesity treatments because a wide swath of the population could be eligible to take them, and patients have to stay on the drugs to keep the weight off.

“There are a lot of people right now who want access to the medication and can’t get it,” said Katherine Hempstead, a Robert Wood Johnson Foundation senior policy adviser.

Coverage varies depending on who pays the bill

Paul Mack dropped about 70 pounds after he started taking Wegovy. The Redwood City, California, resident said food noise — constant thoughts of eating — faded, and he was able to have a heart procedure.

The treatment was covered by California’s Medicaid program, Medi-Cal. Then the 50-year-old security guard got a raise. He no longer qualified for Medi-Cal and lost coverage of the drug for several months starting last summer.

He regained two pants sizes.

“I couldn’t control the eating,” he said. “All the noise came back.”

Coverage of these drugs remains patchy more than a year after Zepbound entered the market to challenge Wegovy.

The benefits consultant Mercer says 44% of U.S. companies with 500 or more employees covered obesity drugs last year. It’s even more common with bigger employers.

More than a dozen government-funded Medicaid programs for people with low incomes also cover obesity treatments.

But few insurers cover the drugs on individual insurance marketplaces. And some plans restrict their coverage with things like requests for prior authorization or pre-approval.

The lack of Medicare coverage remains a concern as well, especially for people who retire and move to the government-funded program from employer-sponsored coverage.

“Patients come to us terrified about switching to Medicare and losing coverage,” said Dr. Katherine Saunders, an obesity expert at Weill Cornell Medicine and cofounder of the obesity treatment company FlyteHealth. “We start talking about backup plans a year before they transition.”

Cost and uncertain payoff loom as concerns payer concerns

Philadelphia-area insurer Independence Blue Cross dropped coverage of the drugs solely for weight loss for some customers starting this year. Company officials say the insurer worried about premium hikes it would have to impose on all customers if it continued.

Cost also was a factor in decisions by West Virginia and North Carolina officials to end similar programs that provided coverage for state employees.

These concerns make Vanderbilt University researcher Stacie Dusetzina wonder how long employers who have added coverage will keep it, now that the drugs are no longer in short supply.

“That’s probably going to spike spending,” said Dusetzina, a health policy professor who studies drug costs.

Drugmakers tout the savings these drugs can provide by improving patient health and warding off future serious medical conditions like heart attacks or strokes.

But health care experts note that there are no guarantees that the employer or insurer who covers the drug will eventually reap those benefits because people may change jobs or insurers.

Will coverage ever become consistent?

There’s no clear path toward widespread coverage of these drugs for obesity, even as polls show Americans favor having Medicaid and Medicare cover the costs.

Leaders at Zepbound maker Eli Lilly have seen coverage grow steadily for their drug, and they’re optimistic that will continue.

Former President Joe Biden’s administration proposed a rule that would allow for Medicare and broader Medicaid coverage. Its fate remains uncertain in President Donald Trump’s administration.

A bill calling for Medicare coverage has been floating around Congress for years. But it isn’t scheduled for a vote.

Drugmakers are currently testing several additional obesity treatments. Such potential competition could reduce prices and prompt more coverage.

Patchy coverage complicates treatment plans

Dr. Amy Rothberg says the lack of consistent coverage leaves her conflicted about writing prescriptions because she’s not sure how long patients will be able to take the drug.

“We know from the studies that people go off these medications, they regain their weight,” said Rothberg, director of the University of Michigan’s weight-management program. “I don’t want to do harm.”

Some insurers require diet and exercise changes for the patient before they will cover a weight-loss medication. Those changes should happen in conjunction with starting the medicine, said Dr. Lydia Alexander, President of the Obesity Medicine Association.

She’s also seen requirements for a body mass index of 40 or more, which equates to severe obesity, before coverage can start.

“We’re saying that obesity is a disease, but we’re not treating it like a disease,” she said.

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Republished with permission of The Associated Press.

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During Monday’s introduction of new Jaguars General Manager James Gladstone, team President Mark Lamping said the timeline for the Jaguars to finalize plans for the 2027 season is fast approaching.

In 2025, the Jaguars will play in EverBank Stadium as renovations continue outside the field. In 2026, stadium capacity will be reduced to around 43,500. The following year, the Jaguars will play home games in Orlando or Gainesville in addition to games in London.

“We’re probably within 30 to 45 days from submitting a report to the National Football League which will summarize our evaluation of all the alternatives,” Lamping said. “We’ll also include a recommendation. The league will receive that. They’ll study that. We’ll have a lot of back and forth.”

It is a rare, but not unprecedented situation for the league to consider. In 2002, the Chicago Bears played home games at the University of Illinois’ Memorial Stadium in Champaign while renovations took place at Soldier Field in Chicago.

In 1998, the Tennessee Titans (then, the Tennessee Oilers) played home games at Vanderbilt Stadium while a new stadium was being built.

The difference in the Jaguars’ situation will be their history of playing in London. It’s possible — even likely — that the Jaguars will play a pair of games in London in 2027, perhaps both “home” games.

Including preseason games, the Jaguars must find sites for 10 “home” games each year. One of the factors to be considered if Gainesville is selected for some of the games is the hotel situation. When the Florida Gators host visiting teams, the opponent usually stays in Ocala, about a 45-minute bus ride from Gainesville.

Orlando has a surplus of hotels that meet or exceed NFL standards.

“If we can get to a consensus, which I’m sure we’ll be able to do that, we’ll then go through the normal NFL approval process,” Lamping added Monday. “It would go to committee meetings in advance of, probably the May owners’ meeting, and then if things advance through the committee process, I think maybe by the May owners’ meeting, there may be something to consider.”

In addition to gaining approval from the league, three-quarters of the NFL owners would also have to approve of the plan.

For now, construction continues outside of EverBank Stadium.

“If you look outside, you’re going to see that there are some areas that are fenced off. There’s some deep pile work that’s going on there,” Lamping said. “You’ll see a crane that’s in the south end of the end zone. Work is going on. It commenced about 45 days ago. So far, no surprises, but a long, long way to go.”

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A federal judge on Monday blocked immigration agents from conducting enforcement operations in houses of worship for Quakers and a handful of other religious groups.

U.S. District Judge Theodore Chang found that a Trump administration policy could violate their religious freedom and should be blocked while a lawsuit challenging it plays out.

The preliminary injunction from the Maryland-based judge only applies to the plaintiffs, which also include a Georgia-based network of Baptist churches and a Sikh temple in California.

They sued after the Trump administration threw out Department of Homeland Security policies limiting where migrant arrests could happen as President Donald Trump seeks to make good on campaign promises to carry out mass deportations.

The policy change said field agents using “common sense” and “discretion” can conduct immigration enforcement operations at houses of worship without a supervisor’s approval.

Plaintiffs’ attorneys argue that the new DHS directive departs from the government’s 30-year-old policy against staging immigration enforcement operations in “protected areas,” or “sensitive locations.”

Five Quaker congregations from Maryland, Massachusetts, Pennsylvania and Virginia sued DHS and its Secretary, Kristi Noem, on Jan. 27, less than a week after the new policy was announced.

Many immigrants are afraid to attend religious services while the government enforces the new rule, lawyers for the congregations said in a court filing.

“It’s a fear that people are experiencing across the county,” plaintiffs’ attorney Bradley Girard told the judge during a February hearing. “People are not showing up, and the plaintiffs are suffering as a result.”

Government lawyers claim the plaintiffs are asking the court to interfere with law-enforcement activities based on mere speculation.

“Plaintiffs have provided no evidence indicating that any of their religious organizations have been targeted,” Justice Department attorney Kristina Wolfe told the judge, who was appointed by President Barack Obama.

More than two dozen Christian and Jewish groups representing millions of Americans have also filed a similar but separate lawsuit in Washington, D.C.

Plaintiffs in the Maryland case are represented by the Democracy Forward Foundation, whose lawyers asked the judge to block DHS enforcement of the policy on a nationwide basis.

“DHS’s new policy gives it the authority to enter any house of worship across the country, no matter its religious beliefs,” the attorneys wrote.

Government lawyers say immigration enforcement activities have been allowed in sensitive places, including houses of worship, for decades. The only change in the policy is that a supervisor’s approval is no longer mandatory, they added.

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Republished with permission of The Associated Press.

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