The Tennessee Department of Finance and Administration’s Division of TennCare has requested significant budget adjustments, including $165 million to account for medical inflation and $118 million to cover increased pharmacy costs. A substantial portion of the requested increase in pharmacy costs, specifically $118 million, is attributed to the growing popularity of glucagon-like peptide-1 (GLP-1) drugs, which are used in medications for type 2 diabetes and weight loss, such as Ozempic and Wegovy.
Understanding GLP-1 Drugs
GLP-1 drugs, or GLP-1 agonists, mimic the GLP-1 hormone naturally released in the gastrointestinal tract in response to eating. According to Harvard Health Publishing, these drugs trigger the release of insulin from the pancreas when carbohydrates are broken down into simple sugars that travel through the bloodstream after eating.
TennCare's Obligation and Funding
TennCare is federally required to cover GLP-1 drugs. Of the requested $118 million increase, over $76 million would be covered by federal funds.
Obesity Action Coalition Applauds TennCare's Decision
The Obesity Action Coalition (OAC) has lauded TennCare's decision to cover obesity medications for beneficiaries 21 years or older, effective August 1, 2025. This decision follows years of advocacy by the OAC and other stakeholders.
A Personal Perspective on Obesity and Advocacy
In April 2024, a past chair of the Obesity Action Coalition (OAC) urged TennCare and the Tennessee Legislature to take obesity seriously. Having struggled with obesity, he has firsthand experience with the health challenges, stigma, unsolicited comments, and dismissive attitudes from healthcare providers that often accompany the disease. He also criticized the "eat less and walk more" advice and gimmick solutions often advertised.
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The Importance of Comprehensive Obesity Treatment
There is significant evidence that comprehensive treatment of obesity improves health outcomes and reduces long-term healthcare costs. By expanding access to FDA-approved obesity medications for Medicaid enrollees, TennCare is signaling that individuals with obesity deserve evidence-based care.
Tennessee as a Model for Other States
At a time when some states are cutting back on Medicaid coverage for obesity care, Tennessee is expanding this coverage. This action demonstrates that state-level initiatives can drive change, even when federal policy progress is slow. Other states should consider Tennessee's decision and consider adopting similar policies.
The Prevalence of Obesity in Tennessee
Tennessee ranks 9th among states affected by obesity, with over 37% of adults living with the disease. The OAC advocates for obesity medications to be covered by insurance in the same way as other chronic diseases, ensuring that costs and coverage do not prevent access to safe and effective treatments.
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