Only 13 state Medicaid programs cover GLP-1 medications for weight loss as of early 2026, down from 17 states before January 1. California, New Hampshire, Pennsylvania, and South Carolina dropped coverage citing budgetary constraints. The 13 remaining states impose strict restrictions including BMI thresholds over 30, prior authorization, and step therapy requirements. CMS introduced the BALANCE demonstration program allowing states to expand coverage through negotiated pricing beginning May 2026.

States are advancing healthcare legislation across three key areas as legislative sessions conclude. Multiple states enacted insurance reforms targeting utilization management and prior authorization, with Iowa, Utah, South Dakota, Washington, and New Mexico leading efforts. Indiana, Wyoming, and Utah passed Medicaid eligibility verification measures responding to federal reforms. Several states expanded scope of practice for pharmacists and mid-level providers to qualify for Rural Health Transformation Program funding.

Despite a December 2025 White House Executive Order threatening to cut BEAD Program funding for states with comprehensive AI oversight, nine states including Alabama, Hawaii, Indiana, Mississippi, Oklahoma, Rhode Island, Tennessee, Virginia, and Vermont have introduced 2026 legislation restricting insurers' use of AI in coverage decisions, with federal review expected by mid-March.

As legislative sessions wind down across the country, attention turns to the executive branch as governors make decisions on bills passed by the legislature. In the past month, various governors have taken action on significant healthcare legislation by signing, vetoing, or allowing bills to become law.