Senate Bill S5798

                                 
BILL NUMBER: S5798

SPONSOR: SEPULVEDA
 
TITLE OF BILL:

An act to amend the social services law, in relation to expanding access
to prescription drugs approved by the FDA for chronic weight management

 
PURPOSE:

To provide Medicaid coverage for prescription drugs approved by the FDA
for chronic weight loss to ensure greater healthcare accessibility and
address the rising epidemic of obesity in our State.

 
SUMMARY OF PROVISIONS:

Section 1 amends the social services law to add a new section 368-g to
require managed care providers and the medical assistance program to
cover prescription drugs approved by the federal food and drug adminis-
tration for chronic weight management in adults with obesity with at
least one weight-related condition.

              

Section 2 sets the effective date as immediately.

 
JUSTIFICATION:

The proposed legislation seeks to ensure that Medicaid prescription drug
coverage includes prescription drugs approved by the FDA for chronic
weight loss.

Obesity is a complex health issue with significant medical, social, and
economic implications. According to the Centers for Disease Control and
Prevention (CDC), obesity affects approximately 42.4% of adults in the
United States, contributing to various chronic conditions such as
diabetes, heart disease, and certain cancers. Despite the availability
of FDA-approved prescription drugs for weight management, many individ-
uals, particularly those from low-income backgrounds, face barriers to
accessing these medications due to limited insurance coverage, especial-
ly in New York State where Medicaid does not presently cover
prescription drugs approved by the FDA for chronic weight loss.

This legislation aims to address this disparity by ensuring that indi-
viduals enrolled in Medicaid in New York State have access to evidence-
based treatment options for managing obesity. It is imperative that
communities from all socioeconomic backgrounds are empowered to pursue
healthier lifestyles, reduce the burden of obesity-related diseases on
our state's healthcare system, and ultimately improve the overall well-
being of our communities. Further, investing in preventative measures
such as weight management can lead to long-term cost savings by reducing
the incidence of obesity-related healthcare expenses. By providing
access to FDA-approved prescription drugs for chronic weight loss
through our state's Medicaid program, we can promote health equity and
support the efforts of individuals striving to achieve and maintain a
healthy weight.

 
LEGISLATIVE HISTORY:

S.9584 of 2023-2024: Referred to Health

 
FISCAL IMPLICATIONS:

Minimal.

 
EFFECTIVE DATE:
This act shall take effect immediately.