Americans elect their leaders on the premise that those individuals will be capable of making the right decisions on difficult, as well as easy, issues.

An issue on which members of Congress might have to render a decision, possibly in the early weeks of the new legislative session, is the kind of topic that could generate opposition and trigger anger, no matter how the decision making shakes out.

The issue is whether Medicare and Medicaid should pay for popular anti-obesity drugs for many more Americans than those already eligible for that benefit.

The Biden administration announced on Dec. 24 that it would initiate a plan to have Medicare and Medicaid cover anti-obesity drugs such as Eli Lilly’s Zepbound and Novo Nordisk’s Wegovy for people who are obese, even if they do not have medical conditions such as diabetes.

Current rules allow Medicare to pay for the drugs in question only if a Medicare enrollee has heart disease or diabetes. Meanwhile, most state Medicaid programs do not pay for the drugs for the obese.

A federal law is at the heart of what is keeping Medicare from covering drugs used for weight loss. However, according to an article in the Nov. 27 edition of the Wall Street Journal, the Biden administration thinks it has found a way to expand coverage without violating that law.

The tactic involves classifying obesity as a disease, although many people, especially those who employ healthy eating habits and steer clear of excessive weight, do not agree with a categorization such as that.

There also is the matter of the taxpayers “picking up the tab” for people whose problem is rooted in their own inability or refusal to deal with their weight issue before it became one of crisis proportion.

With the monthly cost of the drugs being more than $1,000, the Journal said, the Biden administration’s proposal would add tens of billions of dollars in outlays to the Medicare and Medicaid programs.

“Covering treatment for a tenth of Medicare patients who could qualify for the medications would cost more than $26 billion annually, or about a fifth of the federal insurer’s annual drug spending,” the Journal reported, based on a New England Journal of Medicine study published in March 2023.

Because of the incoming Trump administration’s vow to cut federal spending, the Biden plan obviously faces uncertain prospects. However, at the same time, the situation is, in fact, a political dilemma for the new administration because some of its own supporters are in favor of what the Biden administration is choosing to do, in this case.

So, the issue is landing in the laps of U.S. House and Senate members, some of them just beginning their first terms, who will be factoring in the opinions of their constituents with their own personal opinions about what they feel the Biden proposal’s fate should be.

As the Journal pointed out in its Nov. 27 article, the drugs today are in heavy demand after studies found they cut significant amounts of weight and possess other benefits, such as reducing the risk of heart attacks and strokes.

Still, the estimated cost involved could be lessened significantly with guidance and self-control and without so much dependence on the nation’s taxpayers.

The ultimate decision won’t be easy, but the nation’s elected leaders never were promised that it would be.