Health Insurers May Sue if CMS Finalizes Obesity Drug Coverage Expansion

Feb 27
Feb 27, 2025

In comment letters submitted to the federal government, health insurers warn — in so many words — that CMS could be facing lawsuits if it finalizes a rule that expands Medicare and Medicaid coverage of medications that treat obesity.

In fact, at least two comment letters from the health insurance industry point out that a recent Supreme Court decision makes it far easier for courts to determine that federal agencies have overstepped their authority.

“The absence of Chevron deference makes it easier for groups to challenge a regulation on the grounds that it fails to comport with the underlying law, even if under Chevron deference the regulation reflects a reasonable interpretation of the law,” explains Suhasini Ravi, a senior associate at the Center for Health Policy and the Law at Georgetown University’s O’Neill Institute.
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Leslie Small

Leslie has been working in journalism since 2009 and reporting on the health care industry since 2014. She has covered the many ups and downs of the Affordable Care Act exchanges, the failed health insurer mega-mergers, and hundreds of other storylines spanning subjects such as Medicaid managed care, Medicare Advantage, employer-sponsored insurance, and prescription drug coverage. As the managing editor of Health Plan Weekly and Radar on Drug Benefits, she writes and edits for both publications while overseeing a small team of reporters who also focus on the managed care sector. Before joining AIS Health, she was a senior editor for the e-newsletter Fierce Health Payer, and she started her career as a copy editor at multiple local newspapers. She graduated with a dual degree in journalism and political science from Penn State University.