In a move that has left many patients feeling abandoned, California’s Medi-Cal program ended coverage for GLP-1 medications for those with a primary diagnosis of chronic obesity on January 1, 2026. This policy shift has significant implications for thousands of Californians who rely on these medications to manage their health and maintain a healthy body mass index (BMI).
Shekinah Samaya-Thomas, an Oakland resident and member of The Obesity Action Coalition, shares her story of struggle and hope. After decades of battling chronic obesity and trying various treatment options, she found success with GLP-1 medications. However, the recent policy change threatens to undo her progress and return her to a life of health complications.
From Hope to Despair: A Patient’s Journey
Samaya-Thomas’s journey with chronic obesity began decades ago. Despite following doctors’ orders—adhering to nutrition programs, exercising, and even undergoing bariatric surgery—she struggled to maintain a healthy weight. Her highest weight reached 330 pounds, putting her at risk for various chronic diseases.
The turning point came when her doctor prescribed GLP-1 medications. These drugs, which work by mimicking natural hormones in the body, helped her achieve a healthy BMI and significantly lower her blood pressure. For the first time as an adult, she experienced the benefits of stable health. However, the recent Medi-Cal policy change has put this progress at risk.
The Human Cost of Policy Changes
The policy change suggests that patients like Samaya-Thomas should make diet changes and increase exercise. However, this advice ignores the decades many have spent trying to manage their weight through these very methods. It also disregards the overwhelming evidence that obesity is driven by biology, genetics, and environmentnot personal failure.
Without Medi-Cal coverage, Samaya-Thomas and nearly 30% of Californians living with obesity face a daunting challenge. The cost of GLP-1 medications is prohibitive for many, and alternative treatments are not readily available. Losing access to these medications means losing stability, health, and the ability to care for families.
The Broader Impact on California’s Health
The consequences of this policy change extend beyond individual patients. Untreated chronic obesity can lead to expensive conditions such as diabetes, heart disease, sleep apnea, and kidney disease. Managing these conditions costs far more than treating obesity itself. Experts warn that the state may ultimately spend more as patients lose stability and require intensive care.
California prides itself on leading with science, equity, and compassion. However, this policy change reinforces stigma and ignores evidence. It places the burden of treatment on individuals rather than recognizing chronic obesity as a medical condition requiring ongoing care.
Samaya-Thomas urges California state lawmakers to reinstate GLP-1 medication coverage for the treatment of obesity on Medi-Cal. She believes it’s time for California to empower patients to take control of their health and lives. By doing so, the state can lead by example and provide the compassionate, science-based care that its residents deserve.
