As weight-loss medications like Ozempic and Wegovy gain widespread attention, several states across the U.S. are considering legislation that would require insurers to cover these drugs under their health plans.
North Dakota made history on January 1, 2025, by becoming the first state to include weight-loss drugs under the Affordable Care Act (ACA). This move is part of the state’s first update to its essential health benefit (EHB) benchmark plan, which has been in effect since the ACA’s rollout in 2015. The regulatory change, authorized by state lawmakers in 2023, mandates that individual health insurance plans in North Dakota now cover drugs like glucagon-like peptide-1 (GLP-1) and gastric inhibitory polypeptide (GIP), which are commonly prescribed for weight loss, obesity, and diabetes.
These medications, sold under names such as Ozempic, Wegovy, Mounjaro, and Victoza, have garnered significant attention for their effectiveness in weight management. However, despite North Dakota’s pioneering move, other states are approaching the issue through a range of legislative efforts.
The Centers for Medicare & Medicaid Services (CMS) has approved changes to the benchmark plans of Virginia, Alaska, Washington, and Colorado. However, these updates do not mention GLP-1 drugs, leaving many states to consider alternative paths for expanding coverage. A representative from the North Dakota Insurance Department confirmed, “We’re not aware of any states actively seeking to add weight-loss drugs to their EHB,” although multiple states are still exploring ways to include these medications.
As of early 2025, at least 13 states have introduced bills to address GLP-1 coverage for individual health plans, group insurance plans, or Medicaid. Key proposals include:
Arkansas: HB 1332, introduced by Rep. Aaron Pilkington (R), would require the state’s Medicaid program to cover GLP-1 drugs when prescribed for weight loss.
California: AB 575, introduced by Assemblymember Joaquin Arambula (D), would mandate coverage for at least one anti-obesity medication under health insurance plans offering outpatient prescription drug benefits.
Connecticut: Multiple bills, including HB 5038 by Rep. Christopher Rosario (D), would expand state employee weight-loss programs to include GLP-1 medications. Additionally, HB 5485, sponsored by Rep. Geoff Luxenberg (D), aims to establish a captive insurance company for the bulk purchase and distribution of these drugs to qualifying individuals.
Iowa: SSB 1138, introduced by the Senate Health and Human Services Committee, would review the inclusion of anti-obesity medications, including GLP-1 drugs, in public employee health insurance plans.
Mississippi: SB 2867, sponsored by Sen. Kevin Blackwell (R), would provide Medicaid coverage for GLP-1 drugs.
Washington: HB 1197 and SB 5166, introduced by Rep. Timm Ormsby (D) and Sen. June Robinson (D), respectively, propose a report on the potential future inclusion of GLP-1 drugs in the state’s uniform medical plan.
West Virginia: HB 2912, introduced by Rep. Kayla Young (D), would require insurance coverage for GLP-1 drugs when prescribed by a doctor.
These legislative actions reflect growing interest in providing broader access to weight-loss treatments, as states respond to both the increasing popularity of drugs like Ozempic and the rising rates of obesity. With continued discussions on the matter, it seems likely that the debate over insurance coverage for GLP-1 drugs will be a central issue for policymakers throughout 2025 and beyond.
States Consider Expanding Coverage for GLP-1 Weight Loss Drugs
In 2025, a significant shift is underway in healthcare coverage, with numerous states introducing legislation to include GLP-1 weight-loss drugs under health insurance plans, addressing the growing demand for obesity treatments.
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