The Fight for AOM Medicare Coverage Continues with the Medicare GLP-1 Bridge Program

by | Jul 8, 2026 | Blog

AOMs and TROA

Millions of older Americans living with obesity still cannot access FDA-approved anti-obesity medications (AOMs) through Medicare, despite obesity being recognized as a chronic disease. A new Medicare GLP-1 Bridge Program represents an important step toward broader coverage. However, significant barriers remain.

In the last year, the National Hispanic Council on Aging (NHCOA) has made clear that it is in favor of an expanded coverage of Medicare to include AOMs. On a federal policy level, we see the path forward as largely being dependent upon the Treat and Reduce Obesity Act (TROA). TROA was introduced in July, 2023, with the intent of making concise inclusion of drugs under Medicare Part D coverage, when they have been approved by the Federal Food and Drug Administration (FDA) as specifically being an anti-obesity medication. It was most recently re-introduced in June, 2025, and has yet to be passed.

For a long time, there have been FDA approved drugs that could be called an AOM, however instead, they are described as “weight loss” medications. The implication here is that obesity is not being viewed as a chronic disease, and that weight management is something that ties into an individual’s other conditions, even though such conditions are frequently a by-product of obesity. This technical exclusion can be found under section 1860D-2(e)(2) of the Social Security Act.

In November 2024, a brief moment of progress was achieved on this front when the Biden-Harris administration issued a proposal for the expansion of Medicare coverage, specifically under Medicare Advantage and Medicare Part-D. This specifically proposed the coverage of anti-obesity medications (AOMs) for Medicare recipients. This proposal was ultimately shelved, and the expansion of Medicare coverage of AOMs has not yet been achieved.

However, July 2026 poses another moment of hopeful progress, with the Medicare GLP-1 Bridge Program.

So, what is the Medicare GLP-1 Bridge Program?

This Bridge program is a pilot program being run by the Centers for Medicare & Medicaid Services (CMS), wherein eligible Medicare Part D beneficiaries will have access to certain GLP-1 drugs. This program does not change the federal law that excludes medications prescribed for weight loss from Medicare coverage—to do that would require a decision in Congress, such as if TROA were to be passed. However, CMS is using its demonstration authority to temporarily test expansions of coverage for certain GLP-1 medications for eligible Medicare beneficiaries.

The GLP-1 Bridge Program will be available starting July 1, 2026 and ending December 31st, 2027 for a total of one year and six months. An important distinction within this program is that this program does not rely on Medicare Part D, but is a separate system available to Part D beneficiaries. This means that there is no worry about Part D sponsors opting into the program. Eligible beneficiaries will have a $50 copay, which will not go towards their deductible.

The purpose of this test by CMS is also related to another program called the BALANCE Model, which was delayed indefinitely. The BALANCE Model would enable sponsors to opt into providing coverage for GLP-1 drugs prescribed for weight loss, meaning that under this model, certain plans would be able to provide coverage. According to CMS, the data collected from the Medicare GLP-1 Bridge Program will inform future policy decisions, including the potential implementation of the BALANCE Model, meaning that if the Bridge Program sees substantial activity, it could improve the likelihood of AOM coverage in the future. Only eligible Medicare Part D beneficiaries who meet the program’s clinical criteria qualify for coverage. For more information please visit: Medicare GLP-1 Bridge.

Why are AOMs important?

AOMs represent the pharmacotherapy side of obesity treatments. Generally, we are used to the idea of weight loss being related to changes in diet and exercise, which are nutritional and behavioral therapies respectively. While these areas of treatment are important to an individual’s fight with obesity, they are often not enough. It is common for these two types of treatment to show improvement, but not to the extent that would free the individual of the many health risks that come with being obese. 

Individuals experiencing obesity are at much higher risk of cardiovascular disease, which is the leading cause of death in the United States. They are also at higher risk for type-2 diabetes, asthma, pulmonary blood clots, arthritis, stroke, many forms of cancer, and more. 

References:

  • Abdi Beshir, Semira et al. “A narrative review of approved and emerging anti-obesity medications.” Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society vol. 31,10 (2023): 101757. doi:10.1016/j.jsps.2023.101757. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10497995/