Opinion: The case for ending Kentucky’s ban on Medicaid coverage of weight loss drugs

Written by Nancy Glick, Director of Food & Nutrition, National Consumers League

Prescription drug affordability and access are more on the minds of state lawmakers, especially when it comes to covering the weight loss drug GLP-1.

This is now the case in Kentucky where the administration of Governor Andy Beshear has proposed to end the restrictions in state law that prevent the weight loss drug GLP-1 from being covered by Medicaid. While this step has the potential to improve the lives of many Kentuckians, some state lawmakers worry about additional costs and oppose the change.

The truth of the debate among Kentucky lawmakers is not unique. Although obesity is the most common and costly chronic disease in the country, it is often discounted as a serious health problem and thus, obesity remains largely undiagnosed and undertreated. This is why the National Consumers League joined with obesity specialists to issue the nation’s first Obesity Bill of Rights on January 31, 2024. Specifically, the Obesity Bill of Rights defines quality obesity care as the right of all adults and establishes eight important rights, including the right to coverage for a range of obesity treatment options.

Now, due to our work in developing the Obesity Bill of Rights, NCL hopes that our understanding of the benefits of treatment and what GLP-1s are now worth will overcome many of the problems Kentucky lawmakers have raised about lifting restrictions on Medicaid coverage of anti-obesity medications. Here’s what we know:

– Today, an estimated 37 percent of the adult population – or 1.3 million Kentuckians – have obesity. Accordingly, Kentucky ranks 7th among the states most affected by this disease.
Because of the number of adults affected by obesity, medical costs for people with obesity average $1,429 more than those of a healthy weight. Moreover, because obesity worsens the results of more than 230 other chronic diseases, untreated obesity costs the country $6.9 billion annually in health expenditures.
-GLP-1 weight loss medicine is cost-effective, according to the 2025 evidence report from The Institute for Clinical and Economic Review (ICER) on comparative effectiveness and value.
– Covering anti-obesity medications through Medicaid saves the state money. According to the Kentuckiana Health Collaborative, treatments that produce 5 percent to 25 percent weight loss could save Kentucky between $4 billion and $13.4 billion in medical costs over 10 years.
-Treating obesity will improve the health of Kentuckians and reduce rates of chronic disease. Today, there is significant evidence that a modest weight loss of 5-10 percent reduces LDL (“bad”) cholesterol and triglycerides in the blood. Similarly, weight loss of 10-15 percent achieves maximum therapeutic benefits for cardiovascular disease, GERD and conditions such as urinary stress incontinence. Additionally, a 15-20 percent weight loss produces remission of type 2 diabetes and maximal therapeutic benefit for congestive heart failure and cardiovascular mortality.

Finally, the cost of GLP-1 drugs has dropped significantly. Thus, an estimated $1,000 a month for out-of-date treatment. In 2026, the cash price for a monthly supply of injectable semaglutide (Wegovy©) and tirzepatide (Zepbound ©) is between $299 and $499 depending on the dose. As for the new version of the pill, the price varies by dose between $149 and $299 a month and is expected to have a co-pay of $25 or less with insurance. Moreover, due to the agreement with the White House, officials announced that injectable GLP-1s will cost $245 per month, and the new pill will cost $145 a month with co-pays below $50 a month for Medicare enrollees.

Because of this fact, the National Consumers League is appealing to Kentucky lawmakers to ensure that an important right established by the Obesity Bill of Rights – the “Right to Medical Coverage” – applies to Kentuckians. The price tag for maintaining restrictions on coverage of GLP-1 weight loss drugs is too high.

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Nancy Glick is the Director of Food & Nutrition at the National Consumers League and leads the organization’s policy efforts to combat obesity.

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