February 2026 | Policy Brief
Executive Summary
New Mexico is at a critical inflection point. Over the past decade, the state has experienced the fastest rise in obesity rates in the nation, with adult prevalence reaching 36.3 percent and nearly 43 percent among adults ages 25 to 34. This trend disproportionately affects Hispanic, Native American, and Black communities and poses an escalating threat to the state’s Medicaid program, public health infrastructure, and long-term economic stability.
As a majority-minority state with a relatively young population, New Mexico faces a unique and urgent challenge: without early, evidence-based intervention, today’s obesity crisis will become tomorrow’s diabetes, cardiovascular disease, disability, and ballooning Medicaid expenditures. Obesity is a chronic disease linked to more than 200 serious health conditions, including type 2 diabetes, heart disease, stroke, kidney disease, and certain cancers.
Yet New Mexico’s Medicaid Program, Turquoise Care, does not currently cover FDA-approved anti-obesity medications (AOMs), even as these treatments are increasingly recognized as part of the clinical standard of care and are covered in other public and private health plans. This policy gap undermines health equity, limits access to medically necessary care, and leaves low-income New Mexicans without effective treatment options.
When safe, evidence-based care is inaccessible, patients are pushed toward unsafe alternatives, including counterfeit and illegally compounded drugs. These products are increasingly marketed in low-income and border communities and pose serious health risks.
New Mexico has an opportunity to take decisive action. Allocating state funding to support Medicaid coverage of FDA-approved AOMs would advance health equity, improve health outcomes, and help bend the cost curve over time by preventing predictable, high-cost complications such as diabetes and cardiovascular disease.
The evidence is clear, the need is urgent, and the timing is right. This is why we urge the Governor and state lawmakers to appropriate funding to enable Turquoise Care to cover FDA-approved anti-obesity medications.
Obesity Is a Health Equity Crisis
Obesity affects more than 42 percent of adults nationwide and is among the leading drivers of chronic disease in the United States, with profound implications for healthcare costs, workforce participation, and public programs such as Medicaid.[1] Yet despite its scale and impact, obesity is still too often framed as a matter of individual behavior rather than a chronic, multifactorial disease.
As the American Academy of Pediatrics observed in 2023, obesity has been “long stigmatized as a reversible consequence of personal choices,”[2] even though it is shaped by complex genetic, physiologic, socioeconomic, and environmental factors. This misunderstanding has real consequences for policy, particularly because the burden of obesity is not evenly distributed across the population.
Nationally, disparities are stark. Approximately 45.6 percent of Hispanic adults live with obesity, and nearly 79 percent of Hispanic women are overweight or obese, compared with 64 percent of non-Hispanic white women.[3] These national trends are especially salient in New Mexico, a majority-minority state with a relatively young population. Over the past decade, the state has seen the steepest rise in obesity rates in the nation — a ten-point surge that has pushed adult obesity to over 36 percent. The most rapid increase is among adults aged 25 to 34, where nearly 43 percent are now affected.[4]
As this demographic profile intersects with rising obesity rates, the long-term implications for Medicaid and public health in New Mexico are profound. According to the CHOICES Project, nearly 55% of Hispanic adults in New Mexico will be living with obesity by 2030.[5] Left unaddressed, this ticking time bomb will blow a huge hole in the state’s healthcare infrastructure and economy — already costing the state well over $2 billion[6] annually in combined healthcare expenses, lost productivity, and reduced tax revenues.
These projections indicate that, absent meaningful intervention, obesity prevalence among Hispanic adults will continue to rise sharply over the next decade, compounding existing inequities while placing growing strain on state healthcare systems.
Left unaddressed, this trajectory represents not only a threat to individual health outcomes, but a growing risk to the sustainability of Medicaid and the broader healthcare safety net. Treating obesity as the chronic disease it is — as well as responding accordingly — is no longer optional; it is a fiscal and public health imperative. For New Mexico, failing to act now does not save money, rather it defers costs until they are larger, harder to manage, and more inequitable.
The Cost of Inaction | Obesity as a Gateway to Medicaid Spending Growth
Obesity is not an isolated condition. It is a primary risk factor for type 2 diabetes, cardiovascular disease, and numerous other costly chronic illnesses. An estimated 60 to 90 percent of individuals with type 2 diabetes also live with obesity or have a history of obesity.[7]
This connection has direct fiscal consequences:
- Diabetes drives lifelong medication use, frequent hospitalizations, dialysis, amputations, and disability-related care.
- These downstream costs are predictable, recurring, and fall heavily on public payers — particularly programs like Medicaid and Medicare.
Evidence shows that treating obesity earlier can significantly reduce the incidence of type 2 diabetes by as much as 58 percent[8] and delay or prevent the onset of other high-cost complications. Yet despite the availability of effective treatments, obesity pharmacotherapy remains severely underutilized: fewer than 2 percent of eligible adults nationwide receive anti-obesity medications.[9] Failing to address prevention and treatment of obesity means we are giving up on the more than 100 million Americans who already live with this disease and continue to face social stigma.
Ensuring that all eligible Americans can access effective weight-loss therapies would not only improve health outcomes, but also deliver enormous economic value. Fewer obesity-related complications mean less disability, less pain, and up to $100 billion annually in combined healthcare savings and quality-of-life gains. The cost implications are clear: as obesity severity increases, so do medical expenses, rising by nearly 70 percent for class 1 obesity, 120 percent for class 2, and more than 233 percent for class 3.[10]
Anti-Obesity Medications | Evidence-Based, Cost-Effective Care
FDA-approved anti-obesity medications are now widely recognized as part of the standard of care for chronic obesity management, particularly when combined with nutrition counseling and lifestyle interventions. It is unacceptable that many patients do not receive the standard of care needed for obesity, a chronic disease that requires a continuum of evidence-based interventions, beginning with nutritional counseling and structured physical activity and, when clinically appropriate, extending to metabolic surgery and FDA-approved anti-obesity medications.[11] Clinical evidence demonstrates that AOMs:
- Produce sustained weight loss
- Reduce cardiometabolic risk factors
- Improve quality of life
- Lower the risk of progression to type 2 diabetes and cardiovascular disease
Cost concerns often reference official list prices that do not reflect the real, net cost. After rebates and concessions, the estimated net price for medications such as Wegovy is substantially lower — approximately $274 per month[12] — than official list prices. In addition, the federal government pays part of a state’s Medicaid costs through the Federal Medical Assistance Percentage (FMAP). The federal government’s FMAP payment to New Mexico is around 71%,[13] meaning the federal government pays for approximately 71% of Medicaid services in the state.
Importantly, Medicaid programs already use utilization management tools to manage access to specialty medications. Coverage of AOMs does not require abandoning these practices; it requires recognizing obesity as the chronic disease it is and treating it accordingly.
Coverage Gaps Fuel Unsafe Alternatives for New Mexicans
The rapid proliferation of counterfeit and illegally compounded GLP-1 products — often marketed to Latino and border communities — poses a serious and growing public health concern. These products are not FDA-approved and are not subject to adequate safety or quality oversight. The FDA has identified significant risks associated with their use, including improper storage, substandard or unknown ingredients, fraudulent labeling, and reported adverse events.
These dangers are intensified when Medicaid beneficiaries lack access to FDA-approved treatments, leaving patients with limited options beyond unsafe and unregulated substitutes. Expanding Medicaid coverage for evidence-based obesity treatments would not only improve chronic disease management, but also reduce reliance on products that place patients at unnecessary risk.
Across New Mexico, families report persistent barriers to accessing safe, legitimate treatment options and growing exposure to risky alternatives driven by coverage gaps rather than clinical need. This pattern is particularly acute in underserved communities.
The upcoming legislative session presents a critical opportunity to respond. A dedicated appropriation to support Medicaid coverage of FDA-approved anti-obesity medications would save lives, reduce long-term healthcare costs, and protect New Mexicans — especially those in Latino and border communities — from the harms of counterfeit and illegally compounded drugs.
Why Action Is Needed Now
This moment calls for action. New Mexico’s demographic profile — a relatively young, majority-minority population confronting rising obesity rates — magnifies long-term Medicaid exposure and makes inaction increasingly costly. At the same time, there is broad clinical consensus that obesity is a chronic disease requiring comprehensive, evidence-based treatment, not episodic or incomplete care.
Leading health policy experts have reached the same conclusion. As the Institute for Clinical and Economic Review (ICER) recommended in 2022: “States should include coverage of weight loss medications under the auspices of the Medicaid program… Obesity is a growing health problem in the United States that has a particularly large impact on certain racial and ethnic groups… Considerable concern was [also] expressed by patient advocates and clinical experts that despite improvements in weight loss with existing medications and those undergoing clinical evaluation that current coverage policies and medication costs are likely to worsen disparities in accessing care unless specific action is taken.”[14]
Market dynamics further strengthen the case for action. Increased competition and emerging federal pricing signals are expected to continue placing downward pressure on the cost of anti-obesity medications, making expanded coverage more affordable now — and likely even more sustainable over time. Against this backdrop, New Mexico’s longstanding leadership on health equity creates both an opportunity and a responsibility. Expanding Medicaid coverage for obesity treatment represents a logical extension of the state’s commitment to equitable, preventive care. Delaying action will only exacerbate existing disparities and drive higher long-term costs. Acting now offers the chance to improve health outcomes, protect vulnerable communities, and strengthen the long-term sustainability of Turquoise Care.
Sources
This policy brief was developed by the National Hispanic Health Foundation, National Hispanic Council on Aging, League of United Latin American Citizens, MANA, and the American Diabetes Association.
