Faced with high demand for GLP-1 drugs, some American cities and states that previously covered the cost of the weight-loss medication for low-income residents and public employees have now started to restrict or eliminate coverage.

The pullback stems from the dramatic increase in public spending on drugs such as Ozempic and Wegovy in recent years.

Still, some legislators and healthcare providers argue that dropping coverage of the drugs might provide short-term relief for governments but will ultimately harm Medicaid recipients’ health. They argue that cities and states will then have to pay for more health problems related to obesity.

“Patients should have access to these therapies,” said Dr Matthew Klebanoff, a professor of internal medicine at the Perelman School of Medicine who has studied prior authorization policies for GLP-1 drugs. “It’s just very challenging right now for payers to be able to afford covering these medications for everyone who could benefit.”