I 
119TH CONGRESS 
1ST SESSION H. R. 4231 
To amend title XVIII of the Social Security Act to provide for the 
coordination of programs to prevent and treat obesity, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 27, 2025 
Mr. KELLY of Pennsylvania (for himself, Mr. RUIZ, Mrs. MILLER-MEEKS, Ms. 
MOORE of Wisconsin, Mr. PANETTA, Mr. FITZPATRICK, Mr. BOYLE of 
Pennsylvania, Mr. CAREY, Mr. THANEDAR, Mr. COHEN, Ms. NORTON, 
Ms. TLAIB, and Mr. SCHWEIKERT) 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 provi-
sions as fall within the jurisdiction of the committee concerned 
A BILL 
To amend title XVIII of the Social Security Act to provide 
for the coordination of programs to prevent and treat 
obesity, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Treat and Reduce Obe-
sity Act of 2025’’. 
SEC. 2. FINDINGS. 
Congress makes the following findings: 
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(1) According to the Centers for Disease Con-
trol and Prevention, about 41 percent of adults aged 
60 and over had obesity in the period of 2015 
through 2016, representing more than 27,000,000 
people. 
(2) The National Institutes of Health has re-
ported that obesity and overweight are now the sec-
ond leading cause of death nationally, with an esti-
mated 300,000 deaths a year attributed to the epi-
demic. 
(3) Obesity increases the risk for chronic dis-
eases and conditions, including high blood pressure, 
heart disease, certain cancers, arthritis, mental ill-
ness, lipid disorders, sleep apnea, and type 2 diabe-
tes. 
(4) More than half of Medicare beneficiaries are 
treated for 5 or more chronic conditions per year. 
The rate of obesity among Medicare beneficiaries 
doubled from 1987 to 2002 and nearly doubled 
again by 2016, with Medicare spending on individ-
uals with obesity during that time rising proportion-
ately to reach $50,000,000,000 in 2014. 
(5) Men and women with obesity at age 65 have 
decreased life expectancy of 1.6 years for men and 
1.4 years for women. 
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(6) The direct and indirect cost of obesity was 
more than $427,800,000,000 in 2014 and is grow-
ing. 
(7) On average, a Medicare beneficiary with 
obesity costs $2,018 (in 2019 dollars) more than a 
healthy-weight beneficiary. 
(8) The prevalence of obesity among older indi-
viduals in the United States is growing at a linear 
rate and, if nothing changes, nearly 1 in 2 (47 per-
cent) Medicare beneficiaries aged 65 and over will 
have obesity in 2030, up from slightly more than 1 
in 4 (28 percent) in 2010. 
SEC. 3. AUTHORITY TO EXPAND HEALTH CARE PROVIDERS 
QUALIFIED TO FURNISH INTENSIVE BEHAV-
IORAL THERAPY. 
Section 1861(ddd) of the Social Security Act (42 
U.S.C. 1395x(ddd)) is amended by adding at the end the 
following new paragraph: 
‘‘(4)(A) Subject to subparagraph (B), the Secretary 
may, in addition to qualified primary care physicians and 
other primary care practitioners, cover intensive behav-
ioral therapy for obesity furnished by any of the following: 
‘‘(i) A physician (as defined in subsection 
(r)(1)) who is not a qualified primary care phy-
sician. 
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‘‘(ii) Any other appropriate health care 
provider (including a physician assistant, nurse 
practitioner, or clinical nurse specialist (as 
those terms are defined in subsection (aa)(5)), 
a clinical psychologist, a registered dietitian or 
nutrition professional (as defined in subsection 
(vv))). 
‘‘(iii) An evidence-based, community-based 
lifestyle counseling program approved by the 
Secretary. 
‘‘(B) In the case of intensive behavioral therapy 
for obesity furnished by a provider described in 
clause (ii) or (iii) of subparagraph (A), the Secretary 
may only cover such therapy if such therapy is fur-
nished— 
‘‘(i) upon referral from, and in coordina-
tion with, a physician or primary care practi-
tioner operating in a primary care setting or 
any other setting specified by the Secretary; 
and 
‘‘(ii) in an office setting, a hospital out-
patient department, a community-based site 
that complies with the Federal regulations con-
cerning the privacy of individually identifiable 
health information promulgated under section 
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264(c) of the Health Insurance Portability and 
Accountability Act of 1996, or another setting 
specified by the Secretary. 
‘‘(C) In order to ensure a collaborative effort, 
the coordination described in subparagraph (B)(i) 
shall include the health care provider or lifestyle 
counseling program communicating to the referring 
physician or primary care practitioner any rec-
ommendations or treatment plans made regarding 
the therapy.’’. 
SEC. 4. MEDICARE PART D COVERAGE OF OBESITY MEDI-
CATION. 
(a) IN GENERAL.—Section 1860D–2(e)(2)(A) of the 
Social Security Act (42 U.S.C. 1395w–102(e)(2)(A)) is 
amended, in the first sentence— 
(1) by striking ‘‘and other than’’ and inserting 
‘‘other than’’; and 
(2) by inserting after ‘‘benzodiazepines),’’ the 
following: ‘‘and other than subparagraph (A) of such 
section if the drug is used for the treatment of obe-
sity (as defined in section 1861(yy)(2)(C)) or for 
weight loss management for an individual who is 
overweight (as defined in section 1861(yy)(2)(F)(i)) 
and has 1 or more related comorbidities,’’. 
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(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall apply to plan years beginning on or 
after the date that is 2 years after the date of the enact-
ment of this Act. 
SEC. 5. REPORT TO CONGRESS. 
Not later than the date that is 1 year after the date 
of the enactment of this Act, and every 2 years thereafter, 
the Secretary of Health and Human Services shall submit 
a report to Congress describing the steps the Secretary 
has taken to implement the provisions of, and amend-
ments made by, this Act. Such report shall also include 
recommendations for better coordination and leveraging of 
programs within the Department of Health and Human 
Services and other Federal agencies that relate in any way 
to supporting appropriate research and clinical care (such 
as any interactions between physicians and other health 
care providers and their patients) to treat, reduce, and 
prevent obesity in the adult population. 
Æ 
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