I 

118TH CONGRESS 

2D SESSION H. R. 10272 

To amend title XVIII of the Social Security Act to provide coverage of 

weight loss agents for certain individuals under part D of the Medicare 

program. 

IN THE HOUSE OF REPRESENTATIVES 

DECEMBER 3, 2024 

Mrs. CHERFILUS-MCCORMICK (for herself and Mr. KELLY of Pennsylvania) 

introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and 

Means, for a period to be subsequently determined by the Speaker, in 

each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To amend title XVIII of the Social Security Act to provide 

coverage of weight loss agents for certain individuals 

under part D of the Medicare program. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Dual Eligible Ameri5 cans Living with Obesity Act of 2024’’ or the ‘‘DEAL with 

6 Obesity Act of 2024’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) According to the Kaiser Family Foundation, 

4 12.5 million people are dually enrolled in both Medi5 care and Medicaid. 

6 (2) Dual Eligible beneficiaries overwhelmingly 

7 possess limited financial resources, with 87 percent 

8 having an income of less than $20,000 annually. 

9 (3) A one month’s supply of a GLP–1 receptor 

10 agonist, on average, costs between $900 and $1,350. 

11 (4) Coverage of GLP–1 medications can lower 

12 out-of-pocket monthly costs to as little as $25 per 

13 month, according to a study published in JAMA. 

14 (5) Data from the Centers for Medicare and 

15 Medicaid show that 38 percent of Medicaid bene16 ficiaries and 48 percent of Medicare beneficiaries are 

17 affected by obesity. 

18 (6) Obesity is the second leading cause of death 

19 in the U.S., leading to 300,000 deaths per year, ac20 cording to the National Institutes of Health. 

21 (7) Adults in the U.S. living with obesity expe22 rience higher annual out-of-pocket medical costs of 

23 $2,505, on average, compared to those with normal 

24 weight. 


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1 (8) Obesity in the U.S. costs the healthcare sys2 tem $173 billion annually and is projected to cost 

3 the U.S. $550 billion annually by 2030. 

4 SEC. 3. PROVIDING COVERAGE OF WEIGHT LOSS AGENTS 

5 FOR CERTAIN INDIVIDUALS UNDER PART D 

6 OF THE MEDICARE PROGRAM. 

7 Section 1860D–2(e) of the Social Security Act (42 

8 U.S.C. 1395w–102(e)) is amended— 

9 (1) in paragraph (2)(A), in the first sentence— 

10 (A) by striking ‘‘and other than’’ and in11 serting ‘‘other than’’; and 

12 (B) by inserting ‘‘and, with respect to plan 

13 years beginning on or after January 1, 2026, 

14 other than subparagraph (A) of such section if 

15 the drug is approved under section 505 of the 

16 Federal Food, Drug, and Cosmetic Act or li17 censed under section 351 of Public Health 

18 Service Act for long-term weight reduction in 

19 individuals with obesity (as defined in section 

20 1861(yy)(2)(C)) or who are overweight (as de21 fined in section 1861(yy)(2)(F)(i)) and is used 

22 for the treatment of obesity for a specified indi23 vidual (as defined in paragraph (5)) or for 

24 weight loss management for such an individual 


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1 who is overweight,’’ after ‘‘benzodiazepines),’’; 

2 and 

3 (2) by adding at the end the following new 

4 paragraph: 

5 ‘‘(5) SPECIFIED INDIVIDUAL DEFINED.—For 

6 purposes of paragraph (2)(A), the term ‘specified in7 dividual’ means an individual who is eligible for 

8 medical assistance under a State plan under title 

9 XIX (or under a wavier of such plan).’’. 

Æ 


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