Quick Read
- Gov. Newsom proposes ending Medi-Cal coverage for Ozempic and Wegovy for weight loss to reduce costs.
- Cutting coverage could save California up to $680 million by 2028-29.
- Health advocates warn this will hit low-income patients hard, making vital drugs unaffordable.
- Newsom signed a law creating a commission to study trans youth inclusion in sports, sparking debate.
- The commission is seen by some as progressive, but others worry it could lead to restrictions for trans athletes.
Newsom’s Budget Proposal Targets Weight Loss Drug Coverage
California Governor Gavin Newsom has placed himself at the center of a heated debate over public health and fiscal responsibility. His latest budget proposal, revealed Wednesday, aims to slash Medi-Cal coverage for Ozempic and Wegovy—two increasingly popular weight loss drugs. The move, according to Newsom’s office, is a bid to contain ballooning costs in the state’s healthcare program for low-income residents. The numbers are stark: eliminating these drugs from coverage could save California $85 million in 2025-26, and up to $680 million by 2028-29.
Yet, behind these figures lies a deeply human story. For nearly 15 million Californians covered by Medi-Cal, especially the 18 million adults estimated to be obese or overweight, these drugs are more than just line items—they are lifelines. As obesity drives up healthcare costs through related diseases like diabetes and heart disease, weight loss medications have become a crucial tool. But the reality is, once coverage ends on January 1, 619, Medi-Cal patients seeking these prescriptions will face out-of-pocket costs exceeding $1,000 per month—a price tag well beyond reach for most low-income families.
Health professionals are voicing alarm. “This is a bad decision. The people who are already taking this medication, what’s going to happen to them?” asks Liz Helms, president of the California Chronic Care Coalition. Dr. Wayne Ho, a Los Angeles-based obesity specialist, warns that patients are likely to regain weight and lose the health benefits they’ve gained, such as lower blood pressure and cholesterol. “It is the best tool I have had as a primary care physician in practicing preventative medicine,” Ho says, emphasizing the unique challenges low-income patients face, from accessing specialists to affording nutritious food.
On the other side, the California Association of Health Plans argues that the proposal should prompt lawmakers to rethink blanket mandates for coverage without robust clinical safeguards. The state is not federally required to cover these drugs, and Ozempic will remain covered for diabetes treatment under the new plan. Data show a dramatic surge in prescriptions: between 2022 and 2023, Wegovy prescriptions leapt from 15,000 to 181,000, and Ozempic from 178,000 to 480,000. Medi-Cal spent about $733 million on both drugs in 2023, not accounting for manufacturer rebates.
Newsom’s proposal comes amid a $12 billion state budget deficit and a recent $6.2 billion shortfall in Medi-Cal, driven partly by expanded coverage to undocumented immigrants and rising drug costs. As the Legislature prepares to debate the cuts, the governor’s plan is being scrutinized for its impact on vulnerable populations.
Trans Youth Sports: Navigating Inclusion and Controversy
Alongside the budget battle, Newsom is facing another complex issue: the inclusion of transgender youth in sports. Earlier this month, he signed a bill mandating a state commission to study inclusion in youth athletics, with a particular focus on trans youth. The commission’s creation has sparked both praise and apprehension. While some see it as a progressive step toward greater access for all children, others—especially within the LGBTQ+ advocacy community—fear it could pave the way for restrictions on trans athletes.
The backdrop is charged. The bill is seen by some Republican lawmakers as a direct challenge to President Donald Trump’s executive order banning transgender girls from competing in women’s sports. California’s high school athletic policies currently allow students to play on teams that align with their gender identity, following a 2013 state law. But recent changes, such as the California Interscholastic Federation’s (CIF) modified rules for track and field events, reflect growing political pressure and attempts at compromise.
Newsom’s stance has been nuanced, and not without controversy. Despite his history as a champion for LGBTQ+ rights—famously allowing gay couples to marry at San Francisco City Hall—his recent comments in a podcast interview alienated many supporters. “Trust has been shattered,” said Dannie Ceseña of the California LGBTQ Health and Human Services Network. Yet Newsom stands by his remarks, noting, “There’s some nuance here,” and emphasizing the need to balance rights in sports. He advocates for distinctions between competitive and recreational sports for trans kids, while insisting he does not “roll people under the bus.”
Experts point out that athletic ability is shaped by numerous factors, not solely sex assigned at birth. Scientific reviews, including one by the Canadian Centre for Ethics in Sport, indicate that biomedical factors related to puberty do not predict performance. Newsom, who has a trans godson, acknowledges the complexity: “It was an experience for me born over the actual application and responsibility as governor to try to figure this out and I couldn’t. And maybe other people can but I haven’t been able to figure it out.”
The Trump administration has responded by suing the CIF and California’s education department, further intensifying the debate. For families and youth, the issue remains deeply personal. Sports, Newsom notes, were formative in his own upbringing, and he wants all children to benefit—though the path forward is anything but clear.
Balancing Budget Cuts and Social Equity
Both controversies—weight loss drug coverage and trans youth sports—highlight the tension between fiscal constraints and social equity in California. Newsom’s decisions reflect the demands of governing a state with immense diversity and persistent economic challenges. As lawmakers and stakeholders weigh the impact, the stories behind the statistics are a reminder of the real lives affected by policy shifts.
With Medi-Cal’s drug spending soaring and state finances under strain, the governor’s attempt to “tighten things up” may be necessary from a budgetary standpoint, but it raises difficult questions about access and health equity. Similarly, the debate over trans youth sports is a microcosm of broader societal struggles over inclusion, fairness, and identity.
The Road Ahead: Legislative Battles and Community Impact
The next steps will be shaped by legislative debate, advocacy from affected communities, and the practical realities of implementation. Whether it’s low-income patients facing the loss of vital medications, or trans youth navigating the evolving landscape of school sports, Californians are watching closely.
For Newsom, these decisions are more than policy—they’re a test of leadership under pressure. The governor must balance fiscal stewardship with compassion, and ensure that reforms do not inadvertently harm those most in need. As these issues unfold, the outcome will serve as a measure of California’s commitment to equity and inclusion, even in the face of daunting financial and political headwinds.
Newsom’s twin policy challenges—containing Medi-Cal costs and navigating the sensitive terrain of trans youth sports—underscore the complexity of governing in California. His actions reveal a willingness to confront tough fiscal realities, but also expose the deep tensions between economic necessity and the promise of inclusive social policy. The coming months will show whether California’s legislature and its governor can find a path that honors both prudence and progress.