The federal government negotiated discounted prices for weight-loss drugs for state Medicaid programs, opened the door to states in the spring, and set a closing date. Its own model page still lists the number of participants as not applicable.
That gap between a federal pledge and actual coverage is the practical story for Medicaid enrollees who have been waiting to hear whether their state will cover a GLP-1 for obesity. The BALANCE Model, run by the Centers for Medicare and Medicaid Services, allows CMS to negotiate drug prices with drugmakers on behalf of states and Medicare Part D plans. Participation is voluntary for manufacturers, states, and plans, and that word is doing most of the work.
