CMS indefinitely delayed the Better Approaches to Lifestyle and Nutrition for Comprehensive Health (BALANCE) model for Medicare coverage of obesity drugs, after insurers did not sign up for the voluntary plan. CMS said it would extend a temporary Medicare GLP-1 Bridge demonstration through the end of 2027, while the Medicaid version of BALANCE continues in participating states. The move alters the near-term coverage trajectory for seniors and affects the commercial assumptions behind negotiated pricing arrangements with drugmakers. Regulators and payers are now recalibrating how to generate evidence and manage spending under Medicare, a critical determinant of real-world uptake for the GLP-1 and related obesity pipeline.