Medicare covers weight-loss drugs; one year of the One Big Beautiful Bill Act; American medicine at 250 — Morning Medical Update Weekly Recap

Medicare begins covering weight-loss drugs for the first time

A new $50-a-month demonstration called the GLP-1 Bridge routes prior authorization around Part D plans and onto physician desks.

Starting July 1, Medicare began helping pay for GLP-1 drugs prescribed solely for weight loss through a temporary demonstration known as the Medicare GLP-1 Bridge. Patients pay a flat $50 monthly copay regardless of income, but the prior authorization does not run through their Part D plan. Instead it goes to a single central CMS processor most practices have not used, a change likely to bring early delays. Eligibility is based on a patient's BMI and diagnosis at the time GLP-1 therapy began, and patients already receiving a GLP-1 through Part D do not qualify.

KFF estimates as many as 3.8 million beneficiaries could be eligible. The demonstration is set to expire at the end of 2027, with no guaranteed coverage after that.

The One Big Beautiful Bill Act turns one as its health care provisions take hold

A year after it was signed, the law's Medicare pay cliff, Medicaid changes and coverage losses are moving from statute to the exam room.

President Trump signed the One Big Beautiful Bill Act into law on July 4, 2025, and a year later its health care provisions are beginning to take effect.

The Congressional Budget Office estimates the law's Medicaid cuts exceed $1 trillion over 10 years and leave roughly 10 million more people uninsured by 2034; the law also directs $50 billion to a rural health fund, which KFF notes offsets only a fraction of an estimated $137 billion in rural Medicaid reductions. For physicians, the most direct effect is payment: a one-time 2.5% Medicare increase for 2026 expires at year's end, and the AMA says other fee-schedule adjustments already absorb most of it.

Coverage is shifting, too. KFF reported ACA marketplace enrollment fell about 13% after enhanced subsidies expired at the end of 2025, a drop the administration attributes to its fraud-prevention efforts and KFF ties to premium increases. Medicaid work requirements and more frequent eligibility checks also phase in over the next year, and practices should prepare for more coverage churn and a tighter payer mix heading into 2027.

Related content: One Big Beautiful Bill Act — What physicians need to know

As the U.S. turns 250, a look at how far medicine has come

From a few thousand mostly self-taught colonial physicians to a fully credentialed profession and a record-high life expectancy.

As the United States marks its 250th anniversary this Fourth of July, the practice of medicine looks almost nothing like it did at the founding. Historians estimate the colonies had a few thousand physicians, most of them trained by apprenticeship rather than in medical school; the first colonial medical school did not open until 1765.

Life expectancy at birth in the founding era is estimated in the high 30s, pulled down sharply by infant and child mortality. Today, the CDC puts U.S. life expectancy at 79.0 years for 2024, a record high, and medicine has become a fully credentialed profession built on germ theory, antibiotics and vaccination. Even so, the business-of-medicine fights of 2026 — payment, paperwork and staying independent — would look familiar to a physician of 1776.