KEY TAKEAWAYS: Louisiana lawmakers are considering Medicaid coverage for GLP-1 weight-loss drugs starting in January Eligibility would include adults with BMI 35–39 plus related chronic conditions like hypertension or prediabetes Estimated program costs could reach hundreds of millions annua lly but may drop under a federal savings plan Supporters argue the drugs treat a chronic disease, while critics warn of long-term Medicaid budget strain   Louisiana’s Medicaid program could expand access to popular weight-loss medications such as Wegovy and Zepbound for obesity treatment starting in January. The state Senate Health and Welfare Committee moved forward Wednesday with Senate Bill 433, which would allow adults with a body mass index of 35 to 39 to access what are known as GLP-1 drugs for obesity if they have another chronic condition, or comorbidity, including prediabetes, hypertension or cardiovascular disease. The bill’s sponsor, Sen. Gerald Boudreaux, D-Lafayette, said in an interview he brought the proposal at the request of the American Diabetes Association. A body mass index of 35 is the equivalent of a person who is 5 feet 11 inches tall weighing 250 pounds, according to the U.S. Centers for Disease Control. A 5-foot-11 person would have to weigh 272 pounds to have a body mass index of 39. Medicaid recipients in Louisiana can already access GLP-1 drugs, which are also marketed under the brand names Monjauro and Ozempic, if they have a few chronic conditions such as diabetes. But Medicaid coverage for obesity treatment has been extremely limited, in part because of the cost of the drugs. Seth Gold, Louisiana’s Medicaid director, said at the legislative hearing on Boudreaux’s bill the annual treatment for one patient costs around $16,000, and around 145,000 Medicaid enrollees would meet the requirements laid out in the bill to receive the medication. He estimates the expanded coverage could cost as much as $189 million for the first six months of 2027, at least $35 million of which would have to come from the state. During the 2027-28 fiscal year, which starts July 1, 2027, it would cost $296 million, including $55 million in state funding. The balance of those bills would be paid by the federal government. But thanks to a new GLP-1 savings program President Donald Trump negotiated, the price tag could end up being far lower for Louisiana. Gold said the state might only have to pay as little as $7 million for the first six months of 2027 and $11 million the following fiscal year because of the president’s efforts. “We know that this is a blockbuster drug. We know for many people that it is an absolute life changer,” said Louisiana Health Secretary Bruce Greenstein, who added that the state will apply to participate in Trump’s program to lower GLP-1 costs. Douglas Dunsavage, a lobbyist with the American Diabetes Association, said expanding access to obesity treatment will help health care providers prevent chronic illness. “Importantly, obesity is not simply a matter of personal choice or willpower,” Dunsavage said. “It is a chronic relapsing disease” that deserves modern medical treatment. Dr. Katie Queen, who specializes in treating children with obesity, urged lawmakers to consider expanding qualifications for receiving the obesity medication to children. The federal government approved the use of GLP-1 drugs for children starting at age 12 four years ago, she said. Loosening the criteria for weight-loss drug access in the Medicaid program could end up costing the state more money, however. Other states with Medicaid programs that cover obesity drugs have already started scaling back access over concerns about the expense. At least four of the 13 states that offered weight-loss medication for obesity in their Medicaid programs in 2025 have already eliminated the benefit because of financial pressures, according to a KFF report from January. Greenstein said Louisiana needs to make sure it can sustain coverage for obesity-related treatment. “The only thing worse than not starting the program is to start it and then have to stop it” because the state can no longer afford it, he said. ...read more read less