California bill to lower GLP-1 prices through CalRx reaches governor

California's Legislature has sent the governor a bill meant to bring down what the state pays for GLP-1 obesity medicines by having California make or distribute them itself. SB 1089, the Preventive Treatment Health Care Act, was enrolled and presented to the governor on Sept. 3, 2026 ^[1].

The enrolled text, dated Aug. 30, would let the California Health and Human Services Agency form partnerships — conditioned on an appropriation and on the agency concluding they are warranted — to spur competition, cut prices and ease supply shortages for at least one GLP-1 anti-obesity drug with FDA approval ^[1]. Under the bill, the agency would need to set up distribution partners if necessary and use its best efforts to negotiate a price at or beneath the cost Medi-Cal beneficiaries faced in 2025 ^[1].

State Sen. Laura Richardson, an Inglewood Democrat, is the author, and Sen. Jessica Caloza is a co-author ^[1]. Richardson has said she began taking a GLP-1 about a year ago, after learning she was pre-diabetic, and spends $450 a month of her own money because her state health plan will not pay for it ^[2]. "If something is available to help you to be more healthy, to avoid comorbidities … why would we want to wait till a person became diabetic to help them?" she told lawmakers at a June hearing ^[2]. The measure cleared the Senate Health Committee on April 15, 2026, the Senate floor on May 27, the Assembly Health Committee on June 16 and the Assembly floor on Aug. 24 ^[1].

What reached the governor is narrower than the bill as introduced. An earlier version would also have required CalPERS, which insures 1.3 million public employees and retirees, to cover GLP-1s ^[2]. CalPERS fought the measure, saying the drugs' cost would push premiums up by $28 per member each month ^[2].

The bill arrives after California dropped GLP-1 coverage for obesity treatment in Medi-Cal, its Medicaid program, pointing to rising pharmacy costs and budget strain; the state still covers some of the drugs when the prescription is for diabetes ^[2]. Popular GLP-1s such as Ozempic and Wegovy remain out of reach for many residents, and most insurers do not cover them ^[2]. Weight-loss-only prescriptions across Medi-Cal and commercial plans climbed from 20,000 to 700,000 between 2018 and 2023 ^[2]. In 2023, Medi-Cal spent $416.8 million on GLP-1s for weight loss, and commercial payers spent $405.2 million, according to state data ^[2]. The Legislative Analyst's Office found California's pharmacy spending almost doubled in that stretch and linked the increase to drugs for diabetes, obesity and inflammatory conditions ^[2].

CalRx has been slow to deliver. The state needed three years to bring a $55 insulin to market through the program, which also distributes albuterol inhalers and naloxone ^[2].

Why it matters for patients

The bill does not change anyone's coverage on its own. Medi-Cal still excludes GLP-1s prescribed only for obesity, and the legislation would not create that benefit ^[2]. A state-supplied GLP-1, if it happens, is likely years off given the insulin timeline ^[2].

Coverage is a patchwork. Twelve states cover GLP-1s for obesity under Medicaid, while Rhode Island will end that coverage in October ^[2]. New Hampshire, Pennsylvania, Massachusetts and South Carolina recently stopped covering the drugs for weight loss alone ^[2]. Private plans vary widely, and insurers have cited the medicines as a major driver of premium increases ^[2].

Alison Sexton Ward, an economist and research scientist at the University of Southern California, said modeling shows long-term savings and narrower health disparities, but plans must spend heavily up front, and members often change insurers before those savings appear ^[2]. "The thing about treating obesity is just because you lose weight today doesn't mean that your healthcare costs go down tomorrow," she said ^[2].

Patients shut out of coverage sometimes use compounded versions, which Dr. Wayne Ho, an obesity specialist in Los Angeles, said carry more risk because they skip FDA review ^[2]. Poison center calls tied to weight loss drugs rose 1,500% from 2019 to 2025, according to America's Poison Centers, and the FDA has warned about counterfeits ^[2]. A temporary federal Medicare GLP-1 Bridge Program aims to bring Zepbound, Wegovy and Foundayo to about $50 a month ^[2].

What happens next

The bill awaits the governor's signature or veto. A decision deadline has not been reported. Richardson has said she raised the idea of including GLP-1s in CalRx with the governor, who "was very positively open to that," and state health officials have said the drugs are under consideration for the program ^[2].

If enacted, any partnership would still hinge on funding and on the state agency's determination that one is needed; no timeline or price has been disclosed ^[1][2].