Several US states, including California, Pennsylvania, and South Carolina, have ended or restricted Medicaid (the federal-state programme providing free health insurance to low-income Americans) coverage of GLP-1 weight-loss drugs such as Ozempic and Wegovy, as national spending on the medications surged from $13.7bn in 2018 to $71.7bn in 2023. The rollbacks are compounding pressure from federal cuts under Donald Trump's budget legislation, which is set to reduce state Medicaid funding by $665bn over the next decade. Healthcare advocates warn that denying access to the drugs will worsen obesity-related health outcomes in the long run, even as governments seek short-term budget relief.