Conservative Rep. David Schweikert (R-AZ) has long wanted to tighten the U.S. government’s belt. But now, he has a novel idea on how to reduce the deficit: tightening the belts of Americans through Ozempic.
Schweikert wants to expand access to medications that have been shown to assist weight loss, with the rationale that these drugs like Ozempic, Wegovy, and Saxenda—known in the pharmaceutical world as “GLP-1 receptor agonists”—could improve health outcomes for Americans and therefore decrease long term health-care costs.
“Next year, one of the GLP-1s, the Ozempics, goes off-patent,” Schweikert said during a presentation to Four Peaks Young Republicans. “The price is gonna crash. What would happen if you took morbidly obese populations on Medicare, Medicaid, Indian Health Services, the VA and gave them access to it?”
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“It’s not fat shaming; it’s actually fat loving,” Schweikert said. “We can love our brothers and sisters back to health.”
The drug with perhaps the most name recognition, Ozempic, took off on social media as influencers championed the drug as a weight-loss miracle. TikTok users have viewed the Ozempic hashtag 1.3 billion times. Similar drugs like Wegovy have also skyrocketed in popularity.
While social media users tout these drugs as weight-loss marvels, experts have warned that Ozempic’s side effects, which include malnutrition and gastrointestinal problems, aren’t as pleasant as Ozempic obsessives may present. Little is known about the long-term impact of the drug and other GLP-1s.
Ozempic was first developed and FDA-approved as a type 2 diabetes medication. Commercials for the medications used to tout that those taking the drug could experience some weight loss, and it didn’t take long for doctors to start prescribing Ozempic as an “off-label” weight loss medication. Another GLP-1, Wegovy, has the same active ingredient as Ozempic and was FDA-approved for chronic weight management for adults who are overweight.
Many private insurers do not cover drugs for weight loss, often making them prohibitively expensive. Medicare can cover medications for type 2 diabetes, but due to a 2003 law the program cannot cover drugs specifically used for weight loss.
Schweikert mentioned Ozempic by name during his presentation to Four Peaks Young Republicans but, during an interview last week, he emphasized to The Daily Beast that he sees the economic and health benefits of GLP-1 medications broadly.
“It’s more just the concept, what would happen if the most powerful thing you can do on U.S. debt—because debt’s out of control, we’re borrowing over $75,000 a second—is actually through health?” Schweikert asked.
(Schweikert, it should be noted, has had some budgeting problems of his own. His campaign committee agreed to a $125,000 fine for misusing donor money in February 2022.)
Schweikert’s proposal may sound goofy—particularly when there’s so little known about the long-term effects of these drugs—but there’s some wisdom in the idea that drugs like Ozempic could cut pounds and the national deficit. At least to some extent.
The Joint Economic Committee, of which Schweikert is the vice chair, released a report in July that addressed federal health-care spending and obesity. Committee economists project that between 2024 and 2033 government spending on obesity and obesity-related diseases will amount to $4.1 trillion.
“As I have long argued, demographics and disease are primary drivers of our debt,” Schweikert said in his portion of the report.
Expanding access to the GLP-1s, Schweikert told the Young Republicans, could bring “hundreds of millions of dollars of savings on the tax side.”
Schweikert isn’t the only person thinking about Ozempic’s downstream effects. Airlines recently noted that passengers losing weight would require planes to use less fuel, which in turn could save each airline tens of millions.
“It picks up productivity,” Schweikert said of these drugs during his presentation to the Four Peaks Young Republicans. “Populations can participate in the economy.”
But Schweikert, a lean Republican who was a member of the House Freedom Caucus until February, may be overstating exactly how much these drugs could help Americans balance lower numbers on the scale—and the government balance the budget.
An October Congressional Budget Office article cast doubt on the idea that expanding Medicare coverage to GLP-1s for weight loss would bring down the national debt at the moment.
The budgetary effect of Medicare covering anti-obesity medications would depend on drug costs at the time. At current prices, which can come to over $1,000 a month, the CBO assessed that Medicare coverage of drugs like Ozempic for weight loss would “increase overall federal spending.”
The CBO acknowledged that greater use of the medications could improve patient health and reduce the use of other health-care products and services, which could, in turn, lower federal spending on other forms of health care. But the overall effect would depend on the cost of the medications.
“They're very expensive,” Josh Gordon, director of health policy at the Committee for a Responsible Federal Budget, said of these drugs. “I think it is true that Medicare negotiation over time could eventually come for these drugs and lower their prices.”
“But still, drugs in the United States tend to be pretty expensive,” Gordon continued. “They’re obviously developing newer forms of these drugs that might be more effective, lead to greater adherence, but that'll still cost money.”
Jonathan Watanabe, the director of the Center for Data-Driven Drugs Research and Policy at the University of California, Irvine, said studies are showing potential cardiovascular health benefits from these drugs for certain patients—and those benefits may reduce costly hospitalizations, strokes and stays in the intensive care unit.
“It still needs to be evaluated what that actually turns out in terms of dollars,” Watanabe said.
Schweikert said he and other lawmakers looking at the issue are continuing to research the economics of the proposal. He said specific policies are in drafting.
“A lot of what we’re trying to do is get the economics. Is our math correct?” he told The Daily Beast.
Two other lawmakers focused on increasing access to weight loss drugs—Reps. Brad Wenstrup (R-OH) and Raul Ruiz (D-CA), both of whom are doctors—introduced the Treat and Reduce Obesity Act in July. That bill would permit Medicare to cover FDA-approved weight loss drugs. In a statement, Wenstrup also pointed to the potential long-term taxpayer and health-care savings.
Ozempic and Wegovy have been cash cows for its manufacturer, Novo Nordisk. The Danish drugmaker giant spent $2.9 million lobbying the federal government on a range of issues in 2023, including obesity drug coverage and the Treat and Reduce Obesity Act.
Because Medicare does not cover weight loss medications, many people who could benefit from the drugs struggle to get access, according to Yuan Lu, assistant professor of cardiovascular medicine and chronic disease epidemiology at the Yale School of Medicine.
“When we looked at the national data on people with obesity, we found obesity to disproportionately affect minorities and people in low-income, low-socioeconomic-status communities,” said Lu. “If their insurance is not going to cover it, then there’s no way they can afford a medication.”
