TROA is the main federal bill aimed at ending Medicare's exclusion of obesity medications. It was first introduced in 2013, has been reintroduced with bipartisan support in later Congresses, and still hasn't passed.
What TROA is
The Treat and Reduce Obesity Act (TROA) is currently introduced as H.R. 4231 in the House and S. 1973 in the Senate (119th Congress, 2025–2026). It would expand Medicare coverage for obesity treatment, and it's the federal bill most directly tied to the gap described in our guide on the push to get Medicare to cover GLP-1 medications: the 2003 law that created Part D and excluded "agents when used for anorexia, weight loss, or weight gain" from it (42 U.S.C. 1395w-102(e)(2)(A) (external link)).
What it would change
According to the Obesity Action Coalition, TROA proposes two changes to Medicare:
- Medications. Medicare Part D could cover FDA-approved prescription drugs for obesity treatment. Today those drugs are excluded outright by statute, whether or not they're clinically appropriate for a given beneficiary.
- Behavioral therapy. It would broaden Medicare's narrow National Coverage Determination for intensive behavioral therapy for obesity, so more types of healthcare professionals and care settings could deliver it.
Its legislative history
The first version, the Treat and Reduce Obesity Act of 2013 (H.R. 2415 in the 113th Congress), was introduced on June 18, 2013 by then-Rep. Bill Cassidy with bipartisan cosponsors. The bill has been reintroduced in later Congresses with support from both parties, and it has never become law.
In the current Congress, Rep. Mike Kelly (R-PA) introduced H.R. 4231 in June 2025, and it was referred to the House Energy and Commerce and Ways and Means committees. Sen. Bill Cassidy (R-LA) introduced S. 1973 in June 2025 with 17 original cosponsors from both parties, and it was referred to the Senate Finance Committee. Neither bill had advanced out of committee as of September 2026. Bill numbers and sponsors change each Congress, so confirm on congress.gov.
CMS has also pursued an administrative route, the BALANCE Model, for broader Part D obesity-drug coverage. In April 2026 CMS said it would not move forward with the Part D component in 2027, leaving it delayed indefinitely while the Medicaid component proceeds (see the Medicare coverage push). The Obesity Action Coalition's view is that TROA still "remains the primary way for members of Congress to demonstrate support for lasting improvements in obesity care."
Who's behind it
The Obesity Action Coalition (OAC) campaigns for TROA and keeps a page tracking the bill: obesityaction.org/troa (external link). Check it for current status, since the bill's details change from session to session.
How to get involved
TROA is an example of the long, multi-year advocacy described in our guide on the role of patient advocacy organizations in obesity treatment policy. A bill that keeps getting reintroduced needs visible constituent support to keep moving: contact your representatives, support organizations lobbying for it, and check its status each session. If you care about Medicare coverage for GLP-1 medications, this is the federal bill to follow.
This article is general education, not medical, legal, or insurance advice. Coverage rules, appeal rights, and policy details vary by plan and location and change over time. Confirm specifics with your plan, prescriber, or a qualified advisor.