Obesity Groups Support NH Senate Bill 455 to Restore Medicaid Coverage for FDA-Approved Obesity Management Medications

Statement for the Record for April 15 House Commerce and Consumer Affairs Committee Hearing

The Obesity Action Coalition (OAC), The Obesity Society (TOS), and the American Society for Metabolic and Bariatric Surgery (ASMBS) support Committee passage of Senate Bill (SB) 455, introduced by Senator Prentiss, which would restore coverage of FDA-approved obesity medications (OMs) under the state’s Medicaid program. Our organizations support comprehensive coverage for obesity treatment. This includes access to evidence-based and person-centered interventions, including intensive behavioral and lifestyle treatment, FDA-approved obesity medications, and metabolic and bariatric surgery.

Approximately 380,000 adults in New Hampshire are living with obesity, yet many of these individuals lack access to obesity care coverage.¹ The financial burden of treating conditions related to obesity also underscores the need for coverage. For example, the associated health care expenses in New Hampshire from obesity are estimated to reach nearly $2.4 billion annually.¹ However, a number of studies, including two recent ones, show significant return on investment with appropriate obesity medication use and comprehensive obesity care.

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 New Hampshire, 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.

The University of Southern California Schaeffer Center study (2023) on the “Benefits of Medicare Coverage for Weight Loss Drugs” found that treating obesity can reduce diabetes (-8.9%), hypertension (-2.3%), heart disease (-2.6%), cancer (-1.3%), and disability (- 4.7%) over 10 years in private insurance coverage and Medicare. These results would also likely apply to state employee and state Medicaid programs.

In addition, 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, 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 restoring access to obesity medications and treatment in Medicaid will not only improve health outcomes for state residents but will also reduce healthcare costs in the state. Finally, we urge state policymakers to be aware of legislative language used when crafting obesity medication coverage bills. For example, SB 455 uses the term GLP-1 to possibly encompass all FDA-approved obesity medications when, in truth, GLP-1s represent just one class of medications and may preclude others that will be coming as future innovations.

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

[1] American Diabetes 2025 Fact Sheet, https://diabetes.org/sites/default/files/2025-05/the-burden-of-obesity-new-hampshire-05-08-25.pdf