Cost Concerns Limit Medicaid Coverage of Weight-Loss Drugs

A recent survey reveals that most U.S. states do not cover obesity medications in Medicaid due to financial constraints, though some are reconsidering.

• Only 12 state Medicaid programs currently cover obesity drugs like Wegovy and Zepbound, with restrictions on their use.
• Half of the states without current coverage are evaluating the possibility of adding these drugs to their Medicaid programs.
• GLP-1 agonists, initially developed for type 2 diabetes, are priced around $1,000 per month but can be less expensive with insurance or discounts.
• Medicaid spending is projected to rise by 7% in fiscal year 2025, driven by increased costs in healthcare services and pharmaceuticals.
• State Medicaid enrollments are declining post-pandemic, with a 4.4% decrease expected in 2025 following policy changes and funding expirations.

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