What is the Treat and Reduce Obesity Act?

TROA — currently introduced as H.R. 4231 in the House and S. 1973 in the Senate — is federal legislation aimed at expanding Medicare coverage for obesity treatment. It targets the 2003 statutory exclusion of "agents used for weight loss" from Medicare Part D, which is why it's the primary bill to track for Medicare coverage of GLP-1 medications.

What would TROA actually change?

According to the Obesity Action Coalition, it proposes two changes: allowing Medicare Part D to cover FDA-approved prescription drugs for obesity treatment, which are currently excluded outright, and broadening Medicare's narrow coverage rules for intensive behavioral therapy so more types of healthcare professionals and care settings can deliver those services.

No. It has been reintroduced repeatedly across more than a decade of congressional sessions, consistently with bipartisan support, but has not yet passed. According to the Obesity Action Coalition, it remains the primary way for members of Congress to demonstrate support for lasting improvements in obesity care, even as administrative programs like the CMS BALANCE Model pursue access through other mechanisms.

How can I support TROA?

Continued visible constituent support is part of what keeps a repeatedly reintroduced bill moving — contacting your representatives, supporting organizations actively lobbying for it, and staying current on its status each session. The Obesity Action Coalition is a leading advocate for the bill and runs campaigns around it.

Where can I check TROA's current status?

The Obesity Action Coalition maintains a dedicated resource page tracking the bill at obesityaction.org/troa. That's a useful primary source to check, since legislative tracking changes from session to session.

The Treat and Reduce Obesity Act (H.R. 4231 / S. 1973): what it is and why it matters

TROA is the primary federal bill aimed at fixing Medicare's exclusion of obesity medications — reintroduced repeatedly for over a decade with bipartisan support, but not yet passed. Here's what it would actually change.

Updated Jul 18, 2026

What TROA is

The Treat and Reduce Obesity Act (TROA) — currently introduced as H.R. 4231 in the House and S. 1973 in the Senate — is federal legislation aimed at expanding Medicare coverage for obesity treatment. It's the piece of federal legislation most directly connected to the gap covered in our guide on the push to get Medicare to cover GLP-1 medications: the 2003 statutory exclusion of "agents used for weight loss" from Medicare Part D.

What it would actually change

According to the Obesity Action Coalition, TROA proposes two specific changes to Medicare:

Medications: It would allow Medicare Part D to cover FDA-approved prescription drugs for obesity treatment — drugs that are currently excluded outright under the existing federal statute, regardless of clinical appropriateness for a given beneficiary.
Behavioral therapy access: It would broaden Medicare's current, narrowly restrictive National Coverage Determination for intensive behavioral therapy for obesity, allowing more types of healthcare professionals and care settings to deliver these services — not just the limited settings currently permitted.

Its legislative history

TROA has been reintroduced repeatedly across more than a decade of congressional sessions, consistently with bipartisan support, but has not yet passed into law. Separately, the Centers for Medicare & Medicaid Services (CMS) recently launched the BALANCE Model, an administrative program aimed at expanding obesity medication access through a different mechanism than legislation. According to the Obesity Action Coalition, despite that administrative effort, TROA "remains the primary way for members of Congress to demonstrate support for lasting improvements in obesity care" — meaning it continues to serve as the clearest legislative vehicle for this specific policy change, separate from whatever administrative programs exist at a given time.

Who's behind it

The Obesity Action Coalition (OAC) is a leading advocate for TROA, and maintains a dedicated resource page tracking the bill: . This is a useful primary source to check for the bill's current status, since legislative tracking changes session to session.

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Questions people often ask about this topic.

What is the Treat and Reduce Obesity Act?
TROA — currently introduced as H.R. 4231 in the House and S. 1973 in the Senate — is federal legislation aimed at expanding Medicare coverage for obesity treatment. It targets the 2003 statutory exclusion of "agents used for weight loss" from Medicare Part D, which is why it's the primary bill to track for Medicare coverage of GLP-1 medications.
What would TROA actually change?
According to the Obesity Action Coalition, it proposes two changes: allowing Medicare Part D to cover FDA-approved prescription drugs for obesity treatment, which are currently excluded outright, and broadening Medicare's narrow coverage rules for intensive behavioral therapy so more types of healthcare professionals and care settings can deliver those services.
Has TROA become law?
No. It has been reintroduced repeatedly across more than a decade of congressional sessions, consistently with bipartisan support, but has not yet passed. According to the Obesity Action Coalition, it remains the primary way for members of Congress to demonstrate support for lasting improvements in obesity care, even as administrative programs like the CMS BALANCE Model pursue access through other mechanisms.
How can I support TROA?
Continued visible constituent support is part of what keeps a repeatedly reintroduced bill moving — contacting your representatives, supporting organizations actively lobbying for it, and staying current on its status each session. The Obesity Action Coalition is a leading advocate for the bill and runs campaigns around it.

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