New Hampshire Lawmaker Pushes State Coverage for GLP-1 Weight Loss Drugs Like Ozempic
New Hampshire State Senator Sue Prentiss introduced Senate Bill 455 in the 2026 legislative session to require Medicaid coverage for GLP-1 medications prescribed for weight loss in individuals with a body mass index above 30. The bill responds to a recent policy change that, effective January 1, 2026, stopped covering these drugs solely for obesity treatment, with Prentiss saying the legislation aims to recognize obesity as a serious medical condition rather than a cosmetic issue.
The New Hampshire Division of Medicaid Services announced on Oct. 9, 2025, that effective Jan. 1, 2026, Medicaid would no longer cover GLP-1 medications prescribed solely for weight loss, a policy affecting drugs such as Saxenda, Wegovy, and Zepbound, as well as generic versions. Coverage for these medications will continue only when prescribed for chronic conditions including type 2 diabetes, major adverse cardiovascular events, severe obstructive sleep apnea, and Metabolic Dysfunction-Associated Steatohepatitis (MASH), according to agency notifications to Medicaid-enrolled providers.
Fiscal estimates provided by the New Hampshire Department of Health and Human Services (DHHS) indicate that between July 1, 2025, and June 30, 2026, the state paid managed care organizations $49.5 million for GLP-1 medications.
Senate Bill 455, introduced by State Sen. Sue Prentiss in the 2026 legislative session, seeks to reverse this policy by requiring Medicaid coverage of GLP-1 drugs for individuals with a body mass index (BMI) above 30 who are prescribed these medications for weight loss. Prentiss, who qualified for bariatric surgery two years ago due to life-threatening weight-related health risks, said the bill aims to treat obesity as a serious medical condition rather than a cosmetic issue.
After the coverage restriction took effect in January 2026, annual costs dropped to approximately $41 million for covered uses. Resuming coverage for weight loss would increase the state’s expenditure by an estimated $24.2 million per fiscal year, according to DHHS data.
Jonathan Ballard, DHHS chief medical officer, expressed opposition to Senate Bill 455, citing budgetary constraints. Ballard stated the department does not have the funds available to expand coverage and warned that doing so would require significant trade-offs, including cuts to other essential health services. He emphasized the agency’s commitment to operating within current budget limits without additional funding.
Senator Prentiss acknowledged the financial challenges highlighted by DHHS but argued that expanding GLP-1 coverage could prevent the development of chronic conditions such as diabetes, which are associated with obesity and can result in higher long-term healthcare costs. She described the use of GLP-1 medications as essential treatment rather than a cosmetic intervention and cited her own medical history to underscore the life-threatening nature of obesity-related health risks.
Following the policy change, Medicaid providers were instructed to review treatment plans for members currently prescribed GLP-1 drugs for weight loss and to discuss alternative weight management options covered by Medicaid. These alternatives include other medications, physical therapy, home exercise programs, and lifestyle modification programs offered by community organizations, according to guidance issued by the Division of Medicaid Services.
The New Hampshire Insurance Department noted that Senate Bill 455 would expand GLP-1 eligibility beyond current commercial insurance coverage models, which typically limit coverage more narrowly. The bill specifically targets Medicaid recipients with a BMI over 30 seeking treatment for obesity through GLP-1 medications, thereby increasing the covered population under state programs.
The legislative session will continue to consider Senate Bill 455, with further debate expected on the fiscal implications and public health impact of expanding Medicaid coverage for GLP-1 weight loss medications.
