Over 600,000 Californians Risk Losing Access to GLP-1 Weight-Loss Drugs

Over 600,000 Californians who rely on Medi-Cal could lose coverage for GLP-1 weight-loss drugs as of January 1, 2026. The change comes after the California state government decided to restrict coverage of these medications for patients using them solely for weight loss, aiming to reduce costs in the state’s Medicaid program.

GLP-1 drugs, such as Wegovy, Ozempic, Mounjaro, and Zepbound, have gained widespread popularity in recent years as effective tools for weight management. These medications were prescribed to over 660,000 Medi-Cal participants in 2023, according to CalMatters. However, under the new policy, Medi-Cal will only cover these drugs for patients managing chronic conditions like diabetes, heart disease, or chronic kidney disease.

Savings at the Cost of Access

The state’s decision is part of a broader effort to address funding challenges in Medi-Cal. Governor Gavin Newsom’s administration expects the new policy to save $85 million during the 2025-2026 fiscal year and $790 million by 2028-2029. Alongside the changes to GLP-1 coverage, other cost-saving measures include cutting $1 billion in payments for health care coverage for immigrants without legal status.

California is not alone in making these adjustments. President Donald Trump’s decision to cut Medicaid spending by more than $900 billion over the next decade has forced states across the nation to find ways to reduce their Medicaid expenses, including coverage for GLP-1 drugs.

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Impact on Patients

The California Department of Health Care Services has not clarified how many patients prescribed GLP-1 drugs for weight loss alone will lose access. A recent national poll found that 38% of adults who have used these medications did so exclusively for weight loss rather than to treat a chronic condition like diabetes.

The state issued guidance to providers in 2025, recommending that patients at risk of losing coverage be weaned off their medications in the fall. Providers were encouraged to explore alternative treatment options, such as dietary changes, increased exercise, and counseling. However, experts have raised concerns about the potential consequences for patients. According to interviews with the Los Angeles Times, most individuals regain weight once they stop taking GLP-1 drugs, a factor that could harm Medi-Cal participants.

A Controversial Shift

The decision to limit coverage for weight-loss prescriptions has sparked debates over the balance between cost-saving measures and patient health outcomes. As California implements this policy, the effects on affected patients, many of whom rely on Medi-Cal for access to affordable health care, remain uncertain.

With millions of dollars in savings anticipated, the state’s move is a stark example of how budget constraints are reshaping Medicaid programs nationwide. As 2026 begins, the impact of this cost-saving measure will soon be felt by hundreds of thousands of Californians.

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