State Treasurer Brad Briner doesn’t expect North Carolina lawmakers to include requested funding in the new state budget to restore State Health Plan coverage of GLP-1 for weight loss, signaling the benefit is unlikely to return in this budget cycle.
“I’d hoped it would get there this year,” Briner said in an interview with WRAL. “I don’t think that’s likely.”
Other WRAL Top Stories
State lawmakers failed to approve a new budget for the fiscal year starting July 1, 2025. They have been working on a new spending plan after reaching an agreement this month on tax rates and state-employee raises.
House Speaker Destin Hall and Senate Leader Phil Berger didn’t immediately respond to requests for comment Wednesday.
Briner, who is chairman of the State Health Plan, had requested about $100 million to restore funding. But, he said, state leaders indicated they are not planning on fulfilling this request this year.
The State Health Plan, which covers more than 700,000 state employees, teachers, retirees and their families, previously covered GLP-1 medications for weight loss but ended that coverage after costs surged. The plan, which has been working to manage a large shortfall amid rising healthcare costs, still covers the drug as a treatment for diabetes.
GLP-1 medications have been one of the fastest-growing pharmacy costs in the plan. State Health Plan spending on GLP-1 drugs such as Wegovy rose from about $3 million per month in around 2021-2022 to more than $14 million per month in 2023, making In 2023, the drugs accounted for roughly 10% of the $1 billion the plan spends on all prescription drugs.
Briner requested $100 million for the program, which would cover state employees who are deemed to be dangerously overweight, but it does not cover everyone who needs or wants the drug for weight loss. Members of the plan who use GLP-1 medications for diabetes would continue to be covered.
A Senate budget proposal released in 2025 included $25 million of funding to restore GLP-1 coverage for weight loss. The House’s budget proposal from last year included no funds for GLP-1 weight loss coverage.
The State Health plan has been negotiating directly with drug manufacturers to get the prices down for 2026. Briner said if they are successful, it would be possible for the plan to begin coverage without lawmakers help.
Valerie Mendenhall, who has been on GLP-1 medications for several years, said the drugs have changed her life. Her husband is a retired state employee and now bus driver, and they both are unhappy about the loss of coverage on the state plan. She said they hoped lawmakers would have paid for their coverage this year. “I can’t pay for this,” said Mendenhall, who lives in Pittsboro. “My health is at risk. My grandchildren will suffer because I won’t be able to be myself.”
She said her doctor warned weight gain could worsen joint pain and mobility issues, and she had hoped lawmakers would reconsider.
“If I was to gain, you know, say even 25 pounds, that will affect my joints,” she said. “It will affect my momentum. It will affect so many other things.”
Dr. Sarah Ro, director of the University of North Carolina Medical Group’s weight management program, said expanded access could reduce long-term health costs while benefiting patients.
“Providing this group with GLP-1 medications will really, in the long run, reduce the overall health care costs for the state,” Ro said.
Medicaid coverage
Still being debated is whether Medicaid could be used for GLP-1 weight-loss coverage.
Medicaid covers GLP-1 medications for conditions such as diabetes and certain heart-related conditions, but not for weight loss.
In a Medicaid bill signed into law by Gov. Josh Stein last month directed the North Carolina Department of Health and Human Services to develop a plan that would give Medicaid managed care plans greater flexibility in how GLP-1 drugs are covered for conditions beyond diabetes and heart disease. The measure does not require coverage for weight loss.
It remains unclear whether Medicaid could eventually be used to expand GLP-1 coverage for weight loss. State leaders continue budget negotiations and no final policy decisions have been made.
The North Carolina Department of Health and Human Services didn’t immediately respond to a request for comment.