H.R. 4231: Treat and Reduce Obesity Act of 2025
Sponsor
Mike Kelly
Republican · PA-16
Bill Progress
Latest Action · Jun 27, 2025
Referred to 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 provisions as fall within the jurisdiction of the committee concerned. for review
Why it matters
The bill's findings cite $50 billion in Medicare spending tied to obesity in 2014, plus about $2,018 in extra annual costs for each beneficiary with obesity. H.R. 4231 would expand who can provide counseling and let Medicare drug plans cover obesity medications after a 2-year delay.
H.R. 4231 treats obesity less like a side issue and more like an ongoing health condition that affects how you age, what care you need, and what Medicare spends.
The bill's findings cite more than 27 million adults age 60 and older with obesity, around 300,000 deaths a year linked to obesity and overweight, and more than half of Medicare beneficiaries being treated for 5 or more chronic conditions each year. It also says Medicare spending tied to obesity reached $50 billion in 2014.
On the care side, the bill would let Medicare cover intensive behavioral therapy for obesity from more kinds of professionals, including nurse practitioners, physician assistants, psychologists, and dietitians. HHS could also approve community-based lifestyle counseling programs, as long as they work through referrals and coordinate with a physician or primary care practitioner.
On the drug side, Medicare Part D plans would begin covering obesity drugs and weight-loss medications for overweight people with related health conditions. That change would start for plan years beginning 2 years after enactment.
The bill does not include a new pot of money. Instead, it changes what Medicare can pay for and requires HHS to report back to Congress within 1 year, then every 2 years after that, on how the rollout is going.
What does H.R. 4231 do?
More Medicare patients can get obesity counseling
The bill lets HHS expand Medicare-covered intensive behavioral therapy for obesity beyond primary care doctors. That could include physician assistants, nurse practitioners, clinical nurse specialists, clinical psychologists, and registered dietitians or nutrition professionals.
Community weight-loss programs can join Medicare
HHS could approve evidence-based, community-based lifestyle counseling programs to provide covered obesity therapy. Those programs would need to meet federal privacy rules and any other standards the department sets.
Your doctor still stays in the loop
If counseling is provided by a non-primary care provider or an approved community program, it has to happen through a referral from a physician or primary care practitioner. The provider or program also has to send recommendations and treatment plans back to that clinician.
Medicare drug plans start covering obesity medications
Part D plans would be allowed to cover drugs used to treat obesity, plus weight-loss medications for overweight people with 1 or more related health conditions. The coverage change would begin for plan years starting 2 years after enactment.
HHS has to show Congress how this is working
The Secretary of Health and Human Services would have to send Congress an initial implementation report within 1 year, then updated reports every 2 years. Those reports must also include recommendations for better coordination across federal obesity research and care programs.
The bill is built around Medicare's obesity costs
The bill's findings cite $50 billion in Medicare spending tied to obesity in 2014, an estimated $427.8 billion in total direct and indirect obesity costs in 2014, and about $2,018 in extra annual Medicare costs for a beneficiary with obesity.
Who benefits from H.R. 4231?
Medicare patients with obesity
More than 27 million adults age 60 and older with obesity gain access to expanded counseling, behavioral therapy, and drug coverage under Medicare.
Dietitians, psychologists, and nurse practitioners
The bill adds these as Medicare-recognized obesity care providers, opening new billing pathways for professionals who currently can't bill Medicare for obesity counseling.
Pharmaceutical companies making obesity drugs
Medicare Part D drug coverage for obesity treatment creates a large new market for GLP-1 drugs and other anti-obesity medications.
Who is affected by H.R. 4231?
Medicare Part D plans and PBMs
Plans must add obesity-related drug coverage after a 2-year implementation window, requiring new formulary, pricing, and utilization decisions.
Primary care clinicians
Still control referrals and care coordination. The expanded provider list means more specialists competing for the same patients.
CMS and HHS
Must develop quality measures, publish an annual report to Congress, and stand up a multi-agency coordination initiative within 18 months.
H.R. 4231 Common Questions
Would Medicare cover weight-loss drugs under H.R. 4231?
Yes. H.R. 4231 would let Medicare Part D cover drugs for obesity treatment and weight-loss management for overweight people with related health conditions.
When would Medicare start covering obesity drugs?
Not right away. H.R. 4231 says the Part D change would start for plan years beginning 2 years after the bill becomes law.
Who could provide Medicare obesity counseling under H.R. 4231?
The bill lets HHS expand coverage beyond primary care doctors to providers like nurse practitioners, physician assistants, psychologists, and registered dietitians.
Could community weight-loss programs bill Medicare?
Potentially, yes. H.R. 4231 lets HHS approve evidence-based community lifestyle counseling programs to provide covered obesity therapy.
Would you still need a doctor referral for obesity counseling?
Yes. If counseling comes from a non-primary care provider or approved community program, H.R. 4231 requires a referral and ongoing coordination with a physician or primary care practitioner.
How much extra does obesity cost Medicare, according to the bill?
The bill's findings cite about $2,018 more per year for a Medicare beneficiary with obesity than for a healthy-weight beneficiary, in 2019 dollars.
How big does H.R. 4231 say the Medicare obesity problem is?
The bill's findings cite $50 billion in Medicare spending tied to obesity in 2014 and more than 27 million adults age 60 and older with obesity.
Would HHS have to report back to Congress?
Yes. H.R. 4231 requires an initial HHS report within 1 year after enactment, then follow-up reports every 2 years.
Based on H.R. 4231 bill text
HR4231 Legislative Journey
House: Committee Action
Jun 27, 2025
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 provisions as fall within the jurisdiction of the committee concerned.
About the Sponsor
Mike Kelly
Republican, Pennsylvania's 16th congressional district · 15 years in Congress
Committees: Ways and Means
View full profile →
Cosponsors (74)
This bill has 74 cosponsors: 58 Democrats, 16 Republicans, reflecting bipartisan support. Cosponsors represent 31 states: Alabama, Arizona, California, and 28 more.
Raul Ruiz
Democrat · CA
Mariannette Miller-Meeks
Republican · IA
Gwen Moore
Democrat · WI
Jimmy Panetta
Democrat · CA
Brian Fitzpatrick
Republican · PA
Brendan Boyle
Democrat · PA
Mike Carey
Republican · OH
Shri Thanedar
Democrat · MI
Steve Cohen
Democrat · TN
Eleanor Norton
Democrat · DC
Rashida Tlaib
Democrat · MI
David Schweikert
Republican · AZ
Committee Sponsors
Ways and Means Committee
15 of 45 committee members cosponsored
Energy and Commerce Committee
10 of 54 committee members cosponsored
47 Republicans across these committees haven't cosponsored yet. Mobilize their constituents
What laws does H.R. 4231 change?
1 changes
Sections Amended
Section 1861(ddd) of Social Security Act (42 U.S.C. 1395x(ddd))
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 behavioral 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 physician
H.R. 4231 Quick Facts
- Committee
- Ways and Means
- Chamber
- House
- Policy
- Health
- Introduced
- Jun 27, 2025
Referred to 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 provisions as fall within the jurisdiction of the committee concerned. for review
Jun 27, 2025
Constituent Resources
Official Sources
Official bill page with text, cosponsors, committees, and legislative status for the Treat and Reduce Obesity Act of 2025.
Official NIH/NIDDK overview of obesity and overweight, relevant to the bill's findings on health risks and treatment.
Primary CMS manual source for Medicare coverage policy and provider rules relevant to counseling and referral requirements.
Official codified text of Medicare's statutory authority, which this bill would amend under title XVIII of the Social Security Act.
Official Congressional Budget Office page to check whether a cost estimate for H.R. 4231 has been published.
H.R. 4231 Bill Text
“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.”
Source: U.S. Government Publishing Office
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