Major U.S. insurers are cutting coverage for GLP-1 drugs used in obesity care citing steep costs, affecting millions of Americans and intensifying debate over treatment access.
October 13, 2025
Source:
CNN
GLP-1 Coverage Cuts Hit Millions
Who Is Affected?
GLP-1 drugs—including Wegovy, Ozempic, Saxenda and Zepbound—have seen widespread insurance coverage reductions for obesity care across the U.S. in 2025. Source: KFF.
Kaiser Permanente: Ended base coverage in California, with exceptions only via special riders or BMI over 40. LA Times
NC Medicaid: Dropped GLP-1 coverage for obesity from Oct 1, 2025. WRAL
Colorado: State employee health plan coverage removed; some grandfathered with higher copays.
Medicare and Medicaid: No coverage for weight-loss GLP-1s in 2026 due to projected $35 billion/year costs. STAT News
Main Drivers
Surcharges and high medication prices—often $1,000 or more monthly—are cited by insurers as the key reason. Employers face up to a 14% hike in health insurance premiums if these drugs are widely covered, according to analysis by Health Affairs.
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Access Barriers and Patient Impact
Coverage Gaps
As of 2025, an estimated 97 million Americans will lack commercial insurance coverage for new GLP-1 obesity drugs. Another 19 million will have no GLP-1 obesity prescriptions covered at all, per GoodRx.
Restrictions: Many plans that retain some coverage require prior authorizations, high copays, or proof of failed weight management attempts.
Diabetes Use: GLP-1 drugs remain covered for FDA-approved diabetes and cardiovascular risk reduction, but weight loss coverage is only allowed under strict conditions.
Cost Burden
Out-of-pocket costs soar for those losing insurance. Full price is often over $1,000 per month. "Compounded versions are no longer an option due to recent regulatory changes," experts note (FDA).
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