Administration officials reversed a decision made during the Biden presidency that would have given millions of people access to weight-loss drugs paid for Medicare and Medicaid.

The Trump administration on Friday rejected a Biden plan that would have required Medicare and Medicaid to cover obesity drugs and expanded access for millions of people.

Under the law that established Medicare’s Part D drug benefits, the program was forbidden from paying for drugs for “weight loss.” But the Biden administration’s proposal last November had attempted to sidestep that ban by arguing that the drugs would be allowed to treat the disease of obesity and its related conditions.

Expanding coverage of the drugs would have cost the federal government billions of dollars. The Congressional Budget Office estimated the federal expense would amount to about $35 billion over 10 years.

The decision announced Friday was part of a larger 438-page regulation updating parts of Medicare’s Part D drug benefits and Medicare Advantage, the private insurance plans that about half of Medicare beneficiaries now use.

Catherine Howden, a spokeswoman for the Centers for Medicare and Medicaid Services, said in an email that the agency believed that expanding coverage “is not appropriate at this time.” But she said the agency had not ruled out coverage and “may consider future policy options” for the drugs.

Medicare, the government insurance program for Americans over 65 and people with disabilities, does cover the weight-loss drugs for patients with diabetes, and for a much smaller subset of people who are obese and also have heart problems or sleep apnea.