The BALANCE model was originally scheduled to take effect in January 2027 and would have allowed Medicare Part D sponsors to decide whether to cover GLP-1s for weight loss. However, that plan has been delayed, with no indication of when it will now take effect.

Columbus Clinic Adds Structured Medical Weight Loss Workflows Columbus, United States - May 20, 2026 / 1513 Wellness

The BALANCE program was intended to cover weight-loss drugs for Medicaid beneficiaries, but is delayed. A new solution with some downsides takes its place.

The global weight loss industry was valued at $16.3 billion in 2025, yet peer-reviewed clinical validation of program outcomes remains uneven across the categoryRandomized controlled trials control for the lifestyle variables and selection bias that self-reported program data cannot account for,

Mounjaro and Zepbound are two brand-name glucagon-like peptide-1 (GLP-1) medications manufactured by Eli Lilly. Although they contain the same active ingredient, tirzepatide, and may affect blood sugar regulation and weight,