SACRAMENTO, Calif. — Many low-income Californians prescribed wildly popular weight loss drugs lost their coverage for the medications at the start of the new year.
Health officials are recommending diet and exercise as alternatives to heavily advertised weight loss drugs like Wegovy and Zepbound, advice experts say is unrealistic.
“Of course he tried eating well and everything, but now with the medications, it’s better — a 100% change,” said Wilmer Cardenas of Santa Clara, who said his husband lost about 100 pounds over about two years using GLP-1s covered by Medi-Cal, California’s version of Medicaid.
California joined several other states in restricting an option they say is no longer affordable as they confront soaring pharmaceutical costs and steep Medicaid cuts under the Trump administration, among other financial pressures. Despite negotiated price reductions announced in November that the White House said would make the drugs available at a “dramatically lower cost to taxpayers” and enable Medicaid to cover them, states are going ahead with the cuts, which providers say may undermine patients’ health.
“It will be quite negative for our patients” because data shows people typically regain weight after stopping the drugs, said Diana Thiara, medical director of the University of California-San Francisco Weight Management Program.
While California, New Hampshire, Pennsylvania, and South Carolina stopped covering adult GLP-1 prescriptions for obesity on Jan. 1, they continue to cover the drugs for other health issues, such as Type 2 diabetes, cardiovascular disease, and chronic kidney disease.
Michigan, Rhode Island, and Wisconsin are planning or considering restrictions, according to KFF’s most recent survey.
That reverses a trend that saw 16 states covering the medi …