A coalition of Hispanic health and public policy organizations is pushing for New Mexico’s Medicaid program to broaden its coverage of weight loss drugs as treatment for obesity.
The policy change, advocates argue, would curb rising obesity rates, reduce health care disparities for the state’s Hispanic and low-income residents, decrease reliance on compounded or black market weight loss drugs and save on health care spending in the long term.
“We have this breakthrough … that is basically not reaching the population that needs it most,” Dr. Ray Serrano, national director of research and policy for the League of United Latin American Citizens.
The decision would be up to New Mexico policymakers: An exception in federal law makes Medicaid coverage of weight loss drugs to treat obesity optional for states, according to the health research and polling organization KFF. State Medicaid programs must cover the drugs to treat other conditions, like diabetes.
At an estimated cost to the state of at least $9.5 million annually, however, expanding coverage of weight loss drugs to treat obesity may be a prohibitively expensive proposition for New Mexico as it braces to lose Medicaid funding.
The New Mexico Health Care Authority has estimated the state will lose $8.5 billion in federal funding for provider payments between 2028 and 2037, as a result of the 2025 federal budget reconciliation bill signed into law last summer by President Donald Trump and commonly called the “One Big Beautiful Bill Act.”
Nonetheless, the Health Care Authority is “regularly evaluating” coverage of weight loss drugs for obesity, said Keenan Ryan, the state agency’s acting chief medical officer and director of pharmacy.
“We will continue to evaluate the possibility of expanding coverage as the landscape evolves, keeping in mind our mission to help New Mexicans attain their highest level of health by providing whole-person, cost-effective, accessible, and high-quality health care and safety-net services,” Ryan said.
Obesity in New Mexico
In New Mexico, rates of obesity — defined by the U.S. Centers for Disease Control and Prevention as having a body mass index, or a height-to-weight ratio, of 30 or higher — have been on the rise for the past decade, increasing from 26% in 2013 to 35% in 2023, according to data from the state Department of Health.
That’s consistent with nationwide trends. New Mexico’s obesity rate has closely matched that of the United States for more than a decade.
However, obesity doesn’t affect everyone in New Mexico equally. Rates are higher among the state’s Native American and Hispanic residents, in rural communities and for households making less than $25,000 per year, state Health Department data shows.
Research shows people who are obese are more likely to develop other chronic conditions, like high blood pressure, heart disease and Type 2 diabetes. As a result, obesity has earned a spot among the policy priorities of U.S. Health and Human Services Secretary Robert F. Kennedy Jr. and his agency’s Make America Healthy Again agenda.
While many assume curing obesity is a simple matter of personal discipline, the root causes of the condition are complex and greatly influenced by socioeconomic status, health literacy, food availability and infrastructure for physical activity, Serrano said.
He used his own mother — a single mom who worked 16-hour days across two jobs — as an example. Serrano called her the “hardest-working person” he knew — but she also struggled with obesity.
“It wasn’t a choice,” he said. “At no point was she this gluttonous person sitting behind a TV and not working or not exercising. She was actually working … more than most people.”
Fat costs, skinny drugs
Treatment options for obesity were limited for years to bariatric surgery and intensive behavioral therapy, Serrano explained — but the emergence of weight loss drugs has changed that.
Some weight loss drugs are covered under the New Mexico Medicaid Fee-for-Service program with prior authorization from a doctor, according to the state Health Care Authority’s website.
Authorization criteria include a body mass index over 40 or a body mass index over 35 with additional risk factors — such as diabetes or high blood pressure — as well as a recommended six-month trial of caloric restriction and increased exercise.
However, the state’s Medicaid program doesn’t cover Wegovy, “glucagon-like peptide-1 receptor agonists,” or “GLP-1,” drugs in doses meant for treating weight loss specifically.
The challenge is, weight loss drugs come at a steep cost. While the price of weight loss drugs has dropped in recent years — particularly after federal regulators approved the first pill version of Wegovy in December — monthly supplies of the medications can run more than $1,000 for wholesale buyers, according to the government website TrumpRx.gov.
“This class of medications is constantly evolving with new forms, dosages and pricing models,” Ryan said.
Combined, the cost and proliferation of weight loss medication have already brought on a dramatic spike in New Mexico’s prescription drug spending, according to a 2024 analysis by the Legislative Finance Committee.
In 2025, New Mexico lawmakers proposed Senate Bill 193, which would have required insurance coverage of weight loss drugs. While the bill never got a hearing, a fiscal impact report on SB 193 estimated such a requirement would result in between $9.5 million and
$84.2 million in new Medicaid costs for the state, depending on utilization.
Those high prices have led some to seek out weight loss drugs from compounding pharmacies, or pharmacies that prepare medications that aren’t commercially available on-site and typically sell them for a lower price. Still others find the drug on the black market.
Taking too much of a compounded or black market weight loss drug — which can bring on nausea, vomiting, fainting, headaches, dehydration, inflammation of the pancreas, gallstones and other symptoms that sometimes require hospitalization — has resulted in a surge in calls to poison control centers nationwide, including the New Mexico Poison and Drug Information Center.
The U.S. Food and Drug Administration in 2024 warned about patients overdosing on GLP-1 drugs. The New Mexico Department of Justice issued a similar notice to consumers in 2025.
“We’re seeing that compounding surge, a counterfeit surge, targeting certain populations that are again in high need, desperate to get some kind of relief and not seeing the ability to do that through the coverage they have, which in New Mexico is often Medicaid,” Serrano said.
‘It’s a necessity’
The National Hispanic Health Foundation, National Hispanic Council on Aging, League of United Latin American Citizens, American Diabetes Association and the national Latina advocacy organization MANA published a joint policy brief in February, calling on New Mexico to allocate state funding to support Medicaid coverage of weight loss drugs to treat obesity.
The policy brief argues treating obesity now for patients on Medicaid could save the state money in the long run, by avoiding future treatment for heart disease, Type 2 diabetes and other chronic conditions associated with obesity.
Serrano described the cost savings this way: “We’re doing it now, as opposed to letting it balloon up later.”
The brief frames obesity as a health equity issue, particularly given disparate obesity rates faced by Hispanic New Mexicans and other marginalized groups.
“Absent meaningful intervention, obesity prevalence among Hispanic adults will continue to rise sharply over the next decade, compounding existing inequities while placing growing strain on state healthcare systems,” the brief states.
Making weight loss drugs readily available through Medicaid would also steer consumers away from compounded or black market versions of the weight loss drugs, the brief adds.
Serrano said policymakers have been sympathetic to the organizations’ advocacy on weight loss drug coverage — but they maintain cost is a major barrier to implementation.
“Policymakers are still looking at this like it’s a luxury concession,” Serrano said. “We’re not looking at it like it’s a necessity. … You wouldn’t withhold medications for cancer or many other illnesses, chronic diseases — but we are for this.”