A coalition of Hispanic health and public policy organizations is calling on New Mexico’s Medicaid program to expand coverage of weight loss drugs as treatment for obesity. The policy change, advocates argue, would reduce health care disparities for the state’s Hispanic and low-income residents while decreasing reliance on compounded or black market weight loss drugs. An exception in federal law makes Medicaid coverage of weight loss drugs to treat obesity optional for states, though states must cover the drugs to treat other conditions like diabetes.
Obesity rates in New Mexico have risen significantly over the past decade, increasing from 26% in 2013 to 35% in 2023. Rates are higher among Native American and Hispanic residents, in rural communities, and for households making less than $25,000 per year. New Mexico’s obesity rate has closely matched national trends for more than a decade. Research shows people who are obese are more likely to develop other chronic conditions like high blood pressure, heart disease, and type 2 diabetes.
An estimated cost of at least $9.5 million annually to expand coverage presents a significant barrier, as New Mexico braces to lose $8.5 billion in federal Medicaid funding between 2028 and 2037 following the 2025 federal budget reconciliation bill. However, the New Mexico Health Care Authority stated it is “regularly evaluating” coverage of weight loss drugs for obesity. Currently, some weight loss drugs are covered under the Fee-for-Service program with prior authorization, requiring a body mass index over 40 or over 35 with additional risk factors, plus a six-month trial of caloric restriction and increased exercise. The state’s program does not cover weight loss drugs in doses meant for treating obesity specifically.
A 2025 legislative proposal (Senate Bill 193) that would have required insurance coverage of weight loss drugs estimated costs between $9.5 million and $84.2 million, depending on utilization. The high cost of weight loss drugs has driven some to seek compounded or black market versions, leading to a surge in poison control center calls nationwide.
This article is an AI-assisted summary. All facts and figures are drawn from the original report: https://www.santafenewmexican.com/news/local_news/as-obesity-rises-in-new-mexico-advocates-push-for-medicaid-to-cover-weight-loss-drugs/article_6c5d21b2-a147-4f5b-a932-51a8975a59d5.html