Overview

• The pilot program launches in April 2026 for Medicaid and January 2027 for Medicare under the Center for Medicare and Medicaid Innovation’s authority
• The plan reverses an April decision to drop a Biden-era proposal and highlights a policy divide between CMS head Mehmet Oz and HHS Secretary Robert F. Kennedy Jr.
• Annual drug costs of $5,000–$7,000 per patient fuel estimates of about $35 billion in Medicare spending through 2034 and renew questions over budgetary sustainability
• More than 70 million Medicaid enrollees and 65 million Medicare beneficiaries stand to gain obesity drug coverage if their plans opt in, with Eli Lilly’s Orforglipron poised for inclusion pending approval
• Shares of Novo Nordisk and Eli Lilly climbed after reports of the pilot and both companies are boosting U.S. manufacturing capacity ahead of expanded coverage