THE SENATE	S.B. NO.	3195
THIRTY-THIRD LEGISLATURE, 2026
STATE OF HAWAII

A BILL FOR AN ACT

relating to drugs for weight loss.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

SECTION 1. The legislature finds that glucagon-like peptide‑1 drugs, commonly known as GLP‑1 drugs, have been used for decades as an effective treatment for type 2 diabetes mellitus, and drug insurance policies generally provide coverage for these medications when prescribed for that purpose. In recent years, GLP‑1 drugs have also gained significant attention for their effectiveness in treating obesity. However, due to their high cost, insurance coverage for GLP‑1 drugs prescribed for obesity remains relatively limited in Hawaii. In addition, while state medicaid programs must cover nearly all drugs approved by the United States Food and Drug Administration for medically accepted indications, a long‑standing statutory exception under 42 United States Code section 1396r‑8(d)(2)(A) allows states to choose whether to provide medicaid coverage for weight‑loss drugs for adults. As a result, although the United States Food and Drug Administration has approved the GLP‑1 drugs Saxenda (liraglutide), Wegovy (semaglutide), and Zepbound (tirzepatide) for purposes of weight loss, the State of Hawaii department of human services has opted to exclude these medications from coverage under medicaid and medicare part D in most situations.

The legislature believes that GLP-1 drugs should be covered for weight loss purposes, because GLP-1 drugs are effective for addressing obesity, a major health issue linked to diabetes, heart disease, and other conditions. Addressing one of the major contributors to disease will help lower overall healthcare costs for everyone.

Accordingly, the purpose of this Act is to require the department of human services to remove the coverage exclusion for glucagon-like peptide‑1 drugs that have been approved by the United States Food and Drug Administration for weight loss purposes, thereby allowing medicaid and medicare part D coverage for certain glucagon-like peptide‑1 drugs to treat obesity.

SECTION 2. (a) No later than August 1, 2026, the department of human services shall issue temporary rules without regard to chapter 91, Hawaii Revised Statutes, to effectuate subsection (c). The temporary rules shall be effective until amended or superseded by the rules adopted under subsection (b).

(b) No later than January 1, 2028, the department of human services shall adopt rules under chapter 91, Hawaii Revised Statutes, to effectuate subsection (c).

(c) Any patient who is a medicaid or medicare part D prescription drug program recipient shall be eligible for coverage of glucagon-like peptide‑1 drugs as agents when used for weight loss; provided that:

(1) The glucagon-like peptide‑1 drug is approved by the United States Food and Drug Administration for purposes of weight loss;

(2) The glucagon-like peptide‑1 drug is prescribed by a practitioner; and

(3) Prior authorization shall not be required.

For purposes of this Act, "practitioner" shall have the same meaning as in section 461-1, Hawaii Revised Statutes.

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2026-2027 for medicaid and medicare coverage of glucagon-like peptide‑1 drugs as agents for weight loss.

The sum appropriated shall be expended by the department of human services for the purposes of this Act.

SECTION 4. This Act shall take effect on July 1, 2026.

INTRODUCED BY:

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Report Title:

DHS; Weight Loss; Obesity; Medicare; Medicaid; GLP-1; Appropriation

Description:

Requires the Department of Human Services to provide Medicaid and Medicare part D prescription drug program recipients with coverage of glucagon-like peptide-1 (GLP-1) drugs for weight loss. Appropriates funds.

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.