NC budget unlikely to restore GLP-1 coverage

Summary

Treasurer Brad Briner said North Carolina’s next budget was unlikely to restore State Health Plan coverage of GLP-1 drugs for weight loss.

Why this matters

The decision affects more than 700,000 people covered by the State Health Plan and could determine whether some members can afford weight-loss treatment. It also reflects broader budget pressures as state officials weigh rising drug costs against other priorities.

North Carolina State Treasurer Brad Briner said he did not expect lawmakers to include funding in the next state budget to restore State Health Plan coverage of GLP-1 drugs for weight loss.

Lawmakers did not approve a new budget for the fiscal year that starts July 1, 2025. They have continued work on a spending plan after reaching agreement this month on tax rates and state employee raises.

Briner, who chairs the State Health Plan, said he requested about $100 million to restore the benefit, but state leaders indicated they were not planning to fund it this year.

The State Health Plan covers more than 700,000 state employees, teachers, retirees, and their families. It previously covered GLP-1 drugs for weight loss, but ended that benefit after costs rose. The plan still covers the drugs for diabetes.

Briner said the requested funding would have covered state employees deemed dangerously overweight, not everyone seeking the drugs for weight loss. A Senate budget proposal released in 2025 included $25 million to restore coverage, while the House budget proposal last year included no funding for it.

Briner said the State Health Plan was negotiating directly with drugmakers to lower prices for 2026. If those talks succeed, he said, the plan could begin covering the drugs without legislative funding.

Medicaid covers GLP-1 drugs for diabetes and some heart-related conditions, but not for weight loss. A Medicaid bill signed last month by Gov. Josh Stein directed the North Carolina Department of Health and Human Services to develop a plan giving Medicaid managed care plans more flexibility in covering GLP-1 drugs beyond diabetes and heart disease, but it did not require weight-loss coverage.

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