SB544

I support SB 544-FN because it strengthens transparency and accountability in managed care by requiring clearer notice of formulary changes, maintaining coverage during exception reviews, and improving PBM reporting and documentation. These updates protect patients from abrupt disruptions in access and ensure drug coverage decisions are made through a fair, auditable process.

As the Director of a comprehensive weight loss surgery program, I have witnessed firsthand the profound clinical and economic burden of untreated obesity and its related chronic diseases on both patients and our healthcare system. Obesity must be recognized and treated as the chronic, biologically driven disease that it is—not simply a result of individual behavior—and, like medications used to manage hypertension, GLP-1 therapies should be understood as appropriate long-term, often lifelong treatments necessary to effectively control disease and prevent complications. In New Hampshire, adult obesity rates are approximately 31%—lower than the national average of roughly 34–40%—yet still rank around the middle of U.S. states, underscoring that our state is far from immune to this epidemic and its downstream costs. GLP-1 receptor agonists represent a transformative advancement in medical management, offering not only significant and sustained weight loss, but also measurable improvements across multiple chronic conditions including type 2 diabetes, hypertension, cardiovascular disease, and sleep apnea. This unique ability to simultaneously target these diseases distinguishes GLP-1 therapies from traditional treatments and leads to a meaningful reduction in overall healthcare utilization.GLP-1 therapies also serve as a critical adjunct to bariatric surgery (already covered by Medicaid), improving preoperative weight loss to reduce surgical risk and enhancing postoperative outcomes by supporting long-term weight maintenance and reducing recurrence of obesity-related disease. With the anticipated federal cost reductions for these medications taking effect in July 2026, there is a critical opportunity for Medicaid programs to align coverage policies with this new pricing landscape. Expanding Medicaid coverage for GLP-1 therapies is not simply an investment in weight loss—it is a strategic, evidence-based decision that will improve population health outcomes while ultimately reducing total insurance expenditures. Failure to act risks perpetuating higher downstream costs and preventable disease burden among some of our most vulnerable populations.