The use of GLP-1 receptor agonists—medications initially developed for Type 2 diabetes—has surged due to their effectiveness in treating obesity, a condition affecting over 40% of US adults, the Cheyenne Post reports.
However, Medicaid coverage for these obesity-specific drugs, such as Wegovy, Zepbound, and Saxenda, varies significantly across states. Wyoming is among the 14 states that do not cover these treatments for obesity, limiting access for many Medicaid beneficiaries.
GLP-1 medications like Ozempic and Wegovy have gained popularity for their success in managing both Type 2 diabetes and obesity. Yet, their high monthly costs—often exceeding $1,000—make them inaccessible for under- or uninsured patients. While Medicare generally restricts GLP-1 coverage to Type 2 diabetes or heart-related conditions, Medicaid policies for obesity vary widely across the US.
Wyoming Medicaid covers GLP-1s prescribed for Type 2 diabetes, including Ozempic, Mounjaro, and Rybelsus, but it does not include obesity-indicated options like Wegovy or Saxenda. This places the state in a minority, as 36 states now offer Medicaid coverage for at least one FDA-approved GLP-1 for obesity treatment.
Nationwide Medicaid spending on GLP-1 medications has increased dramatically. In January 2020, spending on Ozempic totaled $4.6 million. By October 2024, monthly spending on obesity-indicated GLP-1s like Wegovy surpassed $192 million, contributing to $3.5 billion in total Medicaid expenditures for these drugs over the past year.
Wyoming’s Medicaid spending on GLP-1 medications reflects its restrictive coverage policies. The state spent just over $1 million on GLP-1s in the past 12 months, with a per-enrollee expenditure of $17—well below the national average of $48. By contrast, states with broad coverage, like California and Pennsylvania, recorded per-enrollee spending of $118 and $106, respectively.
States with broad Medicaid coverage for obesity-indicated GLP-1s tend to see higher utilization and spending. For example, 14 states, including California and Michigan, provide comprehensive coverage for Wegovy, Zepbound, and Saxenda. In contrast, Wyoming and 13 other states, including New York and Illinois, exclude obesity-specific GLP-1s from Medicaid coverage altogether, leaving patients with limited treatment options unless they have a Type 2 diabetes diagnosis.
Wyoming’s decision not to cover obesity-indicated GLP-1s reflects broader challenges in balancing healthcare access with cost control. Medicaid beneficiaries in the state can access GLP-1s like Ozempic or Mounjaro for diabetes management but not for obesity alone.
The Biden administration has proposed expanding Medicaid and Medicare coverage for obesity treatments, which could reshape access to GLP-1 medications nationwide. In Wyoming, implementing such changes could address the growing demand for obesity treatments and align the state with broader national trends.
However, even with expanded coverage, questions remain about cost sustainability. Medicaid spending on GLP-1s has grown exponentially, driven by increased utilization and expanded state policies. Policymakers in Wyoming and other states must weigh the potential benefits of improved health outcomes against the financial impact of covering high-cost medications for obesity.
