Obesity Groups Support House Appropriations Committee Passage of SB 433 to Allow for Louisiana Medicaid Coverage of FDA-Approved Obesity Management Medications

The Obesity Action Coalition (OAC), The Obesity Society (TOS), and the American Society for Metabolic and Bariatric Surgery (ASMBS) support House Appropriations Committee passage of Senate Bill (SB) 433, which is sponsored by Senator Boudreaux and would allow for Medicaid coverage of Food & Drug Administration (FDA) – approved obesity management medications in the context of comprehensive obesity care. Improved access to obesity treatments that have been proven safe and effective, including nutrition counseling, behavioral and lifestyle interventions, FDA-approved obesity management medications, endobariatric procedures, and metabolic and bariatric surgery, is critical to ensuring the health and productivity of all state residents.

Louisiana ranks third in states impacted by obesity, with nearly 40 percent of adults living with obesity and another 32 percent affected by overweight. Obesity and diabetes disproportionately affect people of color and of lower socioeconomical status, which are important factors that often determine access to health care. Disparities further exacerbate Louisiana obesity statistics and health outcomes, with more than 47 percent of black and 39 percent of Hispanic residents living with obesity compared to roughly 36 percent of white residents. Persons with low incomes are more likely to be Medicaid recipients or uninsured, have poor-quality health care, and seek health care less often; when they do seek health care, it is more likely to be for an emergency.

The total cost of obesity in the United States is $1.7 trillion, and healthcare costs are 34% higher for people with obesity. Expanding access to obesity care will help decrease the numerous illnesses and associated medical problems that plague citizens of Louisiana, while improving health outcomes and healthcare savings. It is important to remember that while some obesity management medications may be costly, state Medicaid programs receive very generous rebates and discounts from manufacturers and the Federal Government. In addition, creating a system where Medicaid beneficiaries will have access to the full range of obesity treatment services — such as nutrition counseling, intensive behavioral therapy, obesity medications, and metabolic and bariatric surgery — will provide an avenue for addressing so many other costly obesity-related conditions such as Type II diabetes, hypertension, and cardiovascular disease.

Throughout the last 5 years, there have been numerous studies and reports issued on the cost-effectiveness of providing coverage for obesity treatment – with the most recent being the release of the October 29, 2025, Institute for Clinical and Economic Review (ICER) Evidence Report assessing the comparative clinical effectiveness and value of semaglutide and tirzepatide. ICER found all three medications to be highly cost-effective at conventional thresholds, with incremental cost-effectiveness ratios estimated at $53,400 per quality-adjusted life year gained for tirzepatide, $61,400 for injectable semaglutide, and $69,300 for oral semaglutide.

Another example is the October 2025 report from Global Data, entitled the “Economic Benefits of Obesity Treatment,” which assessed previous literature findings on the value of obesity treatments to help policymakers be better informed regarding coverage and policy decisions. This included 31 studies (2012–2025) on the economic value of four major interventions — lifestyle programs, first-generation medications, modern medications, and metabolic and bariatric surgery. The report’s key takeaway was that investing in effective obesity treatments not only improves health outcomes and quality of life but also delivers meaningful savings. The estimated annual medical savings (adjusted to 2025 dollars; varies by insurance type) would be as follows: $200-$1,220 for lifestyle programs and first-gen medications; $760-$4,720 for modern medications; and $940-$5,830 for metabolic and bariatric surgery.

A recent AON study of 139,000 U.S. employees revealed that patients treated with GLP-1 medications experienced a 7% lower medical cost trend by year two compared to similar patients who did not receive treatment for their obesity. In contrast, the untreated group saw their medical cost trend rise to 14%. This is a 50% reduction in health care spending for patients taking obesity medications. Most notably, GLP-1 use led to a greater than 40% reduction in major adverse cardiac events such as heart attacks and strokes and significantly reduced the incidence of diabetes—outcomes that directly benefit both patient lives and the state’s healthcare expenditures. The study was so impactful that the benefits consulting firm started a program to cover these obesity medications for their own employees.

Finally, a recently published article, The Benefits and Costs of Treating Obesity Among Adults in the Medicaid Program, demonstrates that changes in body weight and cardiometabolic risk factors associated with providing specific obesity treatments would reduce the incidence of several chronic conditions, generating multiple social benefits such as medical cost savings, productivity improvements, additional quality-adjusted life-years, and mortality reductions.

• Among people with no prior history of type 2 diabetes, results indicate that second-generation obesity medicines (GLP-1s) can prevent 45% of new cases compared with no treatment.
• Second-generation obesity medicines also would reduce hypertension incidence by 45% and were the most effective across all interventions.
• Coronary heart disease, heart attack, and stroke incidence would decline by rates of 18%, 31%, and 27%, respectively, with use of second-generation OMs.

These studies demonstrate that while medical savings offset only a portion of treatment costs, obesity interventions generate substantial social value through improved long-term health and productivity. These findings support expanded Medicaid coverage as a strategic investment in population health, demonstrating value that challenges conventional short-term, budget-focused coverage decisions that currently limit access to evidence-based obesity treatments for millions of adults.

It is also important to note that the Centers for Medicare and Medicaid Services has invited states to participate in the BALANCE (Better Approaches to Lifestyle and Nutrition for Comprehensive hEalth) model, which broadens access to evidence-based obesity treatments at lower costs through federal negotiations. Meanwhile, increased competition and innovation continue to place downward pressure on GLP-1 prices, and manufacturers have shown a willingness to negotiate directly with states.

Adding coverage for FDA-approved obesity management medications would be a critical step toward ensuring that Medicaid beneficiaries who are affected by obesity have access to affordable, individualized medical coverage for science-based treatments in the same way other chronic diseases are managed, allowing them to be treated with dignity, respect, and equality that is offered to their peers. We collectively believe that expanding access to obesity medications and treatment in Medicaid will not only improve health outcomes for state residents but will also reduce healthcare costs to the state.

For more information, please contact OAC, TOS, ASMBS Public Policy Advisor Chris Gallagher via email at [email protected].