Thousands of Massachusetts residents are on the verge of losing insurance coverage for powerful weight loss drugs that have helped them manage obesity when other treatments have failed.
The impending loss of coverage on July 1 has some of the state’s lowest-income residents, who rely on Medicaid, scrambling to find extra cash to pay for the medicines out of pocket. The costs are steep, typically up to $450 per month.
Some are looking for second or third jobs. Others are dipping into savings. And still others simply cannot afford the extra costs and fear the improvements in their health and weight will deteriorate when their medication runs out.
Emily Putur said she was in tears when she found out her prescription would no longer be covered by the state Medicaid program she is enrolled in, called MassHealth.
“It’s devastating,” said Putur, a 37-year-old shop owner on the North Shore. “Now, I’m forced to pay out of pocket, and I don’t know how long I can sustain that.”
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Injectable weight loss drugs known as GLP-1s have become enormously popular over the last few years. One in five Americans report ever taking a GLP-1 for weight loss or a chronic condition, according to a 2025 poll. But the costs are straining budgets. Private insurers have restricted coverage, or added new approval requirements, and now the state government is doing the same.
MassHealth, which covers about 1.9 million residents with disabilities and those with low incomes, will end coverage for GLP-1 drugs for weight loss on July 1. The change will affect at least 22,000 people, officials said. The Group Insurance Commission, the state agency that provides benefits to public employees in Massachusetts, also plans to stop covering GLP-1 weight loss drugs.
These include the drugs Zepbound and Wegovy. State officials acknowledge the drugs work but say they cannot afford to keep paying for them, especially as they brace for federal budget cuts in the coming years. They say the change will save $15 million a year.
Massachusetts is keeping coverage for GLP-1 drugs to treat certain other conditions, including diabetes.
The policy change is upsetting many patients and doctors. They say obesity is a disease that deserves effective treatments just as much as diabetes and other chronic conditions. In fact, by managing weight, people can lower their risk of developing diabetes, heart disease, liver disease and cancer, said Dr. Caroline Apovian, an obesity medicine specialist in Boston.
“The insurance companies are practicing blatant bias and stigma against people with obesity,” said Apovian, co-director of the Center for Weight Management and Wellness at Brigham and Women’s Hospital.
“If we pay upfront for these life-saving medications, down the line we will reduce healthcare dollars — the billions of dollars we spend on heart disease and diabetes and sleep apnea and liver disease,” she said.
However, studies suggest the savings have not materialized yet.
Apovian said many of her patients with private insurance already lost coverage for their GLP-1s. When they stopped taking the drugs, the weight came back, she said.
“These are drugs that you take indefinitely,” she said. “Obesity is a disease.”
Dr. Richard Siegel, co-director of the Diabetes and Lipid Center at Tufts Medical Center, said most of the dozens of messages he receives from patients every day are about their struggles to access GLP-1 drugs because of insurance restrictions. He spends extra hours each week working to get patients approved for coverage.
“It’s extremely frustrating,” he said.
Some patients decide to switch to less expensive — but less effective — medications. Others opt to pay for GLP-1s out of pocket.
“But I think for the majority on public insurance, it’s just not affordable to do that,” Siegel said. “There’s definitely equity issues.”
“The insurance companies are practicing blatant bias and stigma against people with obesity.”Dr. Caroline Apovian, an obesity medicine specialist
Massachusetts was among just 13 states whose Medicaid programs covered GLP-1s for weight loss at the beginning of 2026, according to the research organization KFF. But several states are pulling back on coverage.
Dr. Ryan Schwarz, assistant secretary for Massachusetts’ Medicaid program, acknowledged the policy restricts medications for those least able to afford to pay out of pocket. But he said the drugs have “ridiculous” prices.
“We do hope in the future, given the impact of these medications, with some changes in the pricing, we may at some point be able to offer these again,” he said. “But right now, unfortunately, it is unsustainable.”
The state’s biggest private insurer, Blue Cross Blue Shield of Massachusetts, also axed coverage of GLP-1 drugs for weight loss this year because the costs were driving up premiums for all members. Blue Cross spent $515 million on GLP-1 drugs last year and was on track to nearly double that spending before changing its coverage policy.
Novo Nordisk, the maker of Wegovy, is “surprised and disappointed” by state officials’ decision to restrict GLP-1 coverage for MassHealth members, spokesperson David McAlpine said.
“Denying patients insurance coverage for safe and effective FDA-approved treatments for a serious and chronic disease is simply irresponsible,” he said.
A spokesperson for Eli Lilly, the maker of Zepbound, encouraged states to join a federal pilot program to offer weight loss drugs to some people on public insurance at a discounted price.
“We want to ensure that people with obesity on Medicaid have access to the medicines they need, and we’ve worked hard to make that affordable for states,” a spokesperson said.
“We may at some point be able to offer these again. But right now, unfortunately, it is unsustainable.”Dr. Ryan Schwarz, assistant secretary for Massachusetts’ Medicaid program
The federal Medicare program, which insures older Americans, is also planning to test an initiative that would make weight loss drugs available to seniors at a lower price.
But for now, most patients on tight budgets are facing difficult choices about giving up medicines that have helped them feel better — or handing over the equivalent of a car payment every month to stay on GLP-1s.
Putur, the patient from the North Shore, said she has struggled with her weight for decades. She has counted calories meticulously and exercised vigorously. At times, she has lost weight only to gain it back later.
After starting a weekly Zepbound regimen last year, Putur said, she has lost 80 pounds and feels more energized. She’s not constantly obsessing over calories.
Putur is not ready to give that up. She said she’s looking for a second job at night, so she can afford the $450 per month cost of Zepbound without insurance.
“ No one enjoys spending a majority of their time at work,” she said. “But it feels like the better option if I have to choose between that — and gaining all the weight back.”
This article was originally published on WBUR.org.
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