In recent months, a growing number of U.S. states have pulled back on covering GLP-1 medications for obesity under their Medicaid programs, even as the drugs remain broadly covered for diabetes. A recent KFF survey shows that while 16 state Medicaid programs still provide coverage, many have begun discontinuing or restricting it.
Medicaid programs in North Carolina, South Carolina, Michigan, New Hampshire, and California have announced plans to eliminate or narrow access to GLP-1 weight-loss treatment – in some cases limiting it only to people who are “morbidly obese.” The reversal reflects tightening budgets, slowing revenue growth, and rising spending demands.
The private sector is feeling similar pressure. Recent financial reports show that some insurers spent more on drugs in the first nine months of the year than they did in all of 2024, with GLP-1 demand playing a central role. Large employers have also reported substantial cost increases tied to GLP-1 coverage, prompting many to re-evaluate their benefit design.
For self-funded employers, these pressures point to a clear tension: GLP-1s offer meaningful clinical benefits, but broad coverage remains difficult to sustain. MedBen Rx works to balance long-term health outcomes with practical plan management, emphasizing lifestyle and nutrition programs supported, when appropriate, by proven medical therapies.