March 13, 2025

Washington, D.C. — The Health Equity Coalition for Chronic Disease (HECCD) released the below statement following the unveiling by the Centers for Medicare & Medicaid Services (CMS) of the Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth (BALANCE) model — which will allow Medicare to cover GLP-1s for patients with obesity who meet certain criteria. The model — which state Medicaid plans can opt into — will begin in January 2027. CMS has also directed Medicare to begin providing coverage for GLP-1s in July of 2026 under the Medicare GLP-1 Bridge. 

“We are pleased that CMS has decided to take steps to provide Medicare and Medicaid beneficiaries with coverage of GLP-1s for the treatment of obesity. GLP-1s have increasingly been recognized as part of the clinical standard of care and for too long people living with obesity, particularly those disproportionately affected by chronic conditions, have been unable to access the full continuum of care. We hope this demonstration further exemplifies the need for Medicare and Medicaid coverage. 

“We encourage all Part D plans and states to participate in the program, expanding this critical care to beneficiaries. We also encourage CMS to permanently expand fulsome coverage for all beneficiaries who have been prescribed a GLP-1 by a medical provider — especially for people living in rural communities, older Americans, and people of color who are disproportionately affected by chronic conditions.”

The unveiling of the BALANCE Model follows CMS’s announcement in December that it would be launching a new voluntary test of a model designed to enable Medicare Part D plans and state Medicaid agencies to cover GLP-1 medications.

Obesity’s Toll on Americans

Obesity is a costly epidemic that takes a $170 billion toll on our nation annually, and it’s getting worse: An estimated 42% of American adults are currently living with obesity and some studies estimate that more than half of Americans will be living with obesity by 2030. Despite it being designated a chronic disease for well over a decade, obesity is treated differently by Medicare and Medicaid, which do not provide the clinical standard of care that millions of Americans deserve. Treatment professionals should have every tool in the toolbox — from intensive behavioral therapy around diet and exercise and medication treatment or surgery as appropriate — to improve the health of older Americans living with obesity.