California Drops Ozempic Coverage for 500,000 Low-Income Residents

Medi-Cal Cuts Hit January 1, 2026

If you rely on Medi-Cal for your Ozempic or Wegovy prescription, the clock is ticking. California just ended coverage for GLP-1 weight loss drugs, and the change took effect on New Year’s Day.

More than half a million people were using these medications through the state’s Medicaid program.

Now they face a choice: pay hundreds of dollars a month out of pocket, or stop taking drugs that most people cannot quit without gaining back everything they lost.

660,000 People Got These Drugs Through Medi-Cal

In 2023, over 660,000 Californians received GLP-1 medications through Medi-Cal, the state health insurance program for low-income residents and people with disabilities. That number had been climbing fast.

Between 2022 and 2023, Wegovy prescriptions in the program jumped from 15,000 to 181,000. Ozempic prescriptions rose from 178,000 to 480,000 during the same period.

The drugs became a lifeline for people who had struggled with weight loss for years.

The State Spent $1.6 Billion in One Year

The bill got expensive. In 2024, California’s Medi-Cal program spent $1.6 billion on just two drugs: Ozempic and Wegovy.

Together, they accounted for nearly 10 percent of all prescription costs in the program.

That kind of spending put pressure on a state budget already facing a $12 billion deficit. Something had to give, and Governor Gavin Newsom decided these drugs would be part of the cut.

Newsom Says It Saves $790 Million

The governor’s office projects the GLP-1 coverage change will save $85 million in the current fiscal year and up to $790 million by 2028-29.

The cuts were part of a larger budget deal that also slashed $1 billion in health care payments for immigrants without legal status.

Newsom’s administration framed the decision as necessary to keep Medi-Cal sustainable for the 15 million Californians who depend on it.

Diabetes Patients Still Qualify for Coverage

The cut is not total. If you take Ozempic, Mounjaro, or similar drugs for Type 2 diabetes, heart disease, or chronic kidney disease, Medi-Cal will still cover your prescription.

The same goes for Wegovy if it is prescribed for certain liver conditions or cardiovascular disease. The change specifically targets people who were prescribed these medications only for weight loss.

Exactly how many patients fall into that category is unclear, because the state could not provide an estimate.

These Drugs Now Cost $350 a Month

For patients who lose coverage, paying out of pocket is the only option. Novo Nordisk, the maker of Ozempic and Wegovy, recently dropped its cash price to $349 per month.

That is still far out of reach for people who qualify for Medi-Cal, where a single person’s annual income cannot exceed $21,597. At $350 a month, the drugs would eat up nearly 20 percent of that income.

For most, that math simply does not work.

Most People Regain the Weight

Here is the problem with stopping: it almost never sticks.

Research shows that people who discontinue GLP-1 drugs regain about two-thirds of the weight they lost within one year.

A recent study found that patients who stopped semaglutide gained back an average of 11.6 percentage points of their lost weight. Blood pressure, cholesterol, and blood sugar levels tend to creep back up too.

The drugs work, but only as long as you keep taking them.

Doctors Call It a Bad Decision

Medical professionals are not happy. Dr.Wayne Ho, a Los Angeles obesity specialist, told reporters that GLP-1 drugs are the best tools he has ever had for preventive medicine.

He said patients will likely regain the weight they lost and also lose health benefits like lower blood pressure and cholesterol.

Liz Helms, president of the California Chronic Care Coalition, called the decision bad and asked what would happen to people already on the medication.

18 Million California Adults Are Overweight

California has one of the lowest adult obesity rates in the country at around 28 percent, but that still translates to 8. 5 million obese adults.

Another 9.5 million are overweight. Obesity drives up health care costs because it leads to diabetes, heart disease, and other chronic conditions.

The state spends more on obesity-related medical care than any other state in the nation.

Cutting the drugs that help people lose weight could end up costing more in the long run.

Five Other States Made the Same Cut

California is not alone. Pennsylvania, North Carolina, New Hampshire, and South Carolina have all ended or restricted Medicaid coverage for GLP-1 weight loss drugs in recent months.

North Carolina cited shortfalls in state funding. Pennsylvania projected the change would save $380 million through the end of the next fiscal year.

States that once saw these drugs as a breakthrough are now backing away as costs pile up and budgets tighten.

Federal Medicaid Cuts Forced States to Choose

The timing is no coincidence. In July 2025, President Donald Trump signed a law that cut federal Medicaid spending by more than $900 billion over the next decade.

States are now scrambling to find savings wherever they can.

The Congressional Budget Office estimates the cuts will cause 10 million people to lose coverage by 2034.

GLP-1 drugs, with their high price tags and growing demand, became an obvious target for states looking to trim costs.

A Federal Program Could Help, But Not Yet

There is a glimmer of hope on the federal level. The Trump administration announced a new program called BALANCE that would let Medicare patients get GLP-1 drugs for $50 a month starting in mid-2026.

State Medicaid agencies can also join the program, which involves negotiated pricing with drug manufacturers. But for the 500,000 Californians who just lost coverage, that help is not coming soon enough.

They are on their own.

This article was created with AI assistance and human editing.

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