Opinion: As Obesity Crushes Our Communities, California Can’t Afford to Cut Care
Obesity is a structural and systemic health crisis that demands a public health response.
By Rhonda Smith | Special to California Black Media Partners
Obesity is a structural and systemic health crisis that demands a public health response.
Across California, nearly one-third of adults are living with obesity, according to data from UCLA. But behind this number lies a deeper truth: obesity is a disease, not a choice, and Black and Brown communities are bearing the brunt of its consequences.
The proposed budget cuts to Medicaid/Medi-Cal threaten to make things significantly worse.
Obesity is linked to a host of chronic diseases, including diabetes, heart disease, and stroke, all of which Black and Brown communities experience with worse outcomes and higher disease-related deaths. These health conditions drive nearly half the cost of chronic disease care in the U.S., draining both lives and livelihoods. And the burden is not shared evenly. In California, 36.8% of Black adults are living with obesity, which is significantly higher than the state average.
Under-resourced communities already face barriers to accessing quality healthcare nutritious food, safe places to be active, and culturally competent healthcare providers.
California has the highest total obesity-related medical costs in the United States, with annual medical care expenditures of adults with obesity nearly three times greater than for adults with normal weight, the greatest difference of any state.
Recent studies show that the obesity rate in California is projected to increase to 41% by 2030. Cutting access to effective, evidence-based treatments will exacerbate the disparities and costs — particularly for newer classes of medications, such as GLP-1 drugs.
These medications are proving to be effective not just at managing obesity, but at reducing downstream health conditions and costs. A recent workforce analysis from Aon found that individuals using GLP-1s saw a measurable reduction in healthcare spending, which could also result in potential gains in productivity and fewer workdays lost to illness.
However, this isn’t just about cost containment, it’s about transforming our healthcare system into one that provides quality, equity-centered care for everyone. The state’s proposed budget will cut GLP-1 coverage under Medi-Cal, effectively denying access to these treatments for low-income and vulnerable Californians. At a time when we should be expanding healthcare access, the pending budget cuts will harm many Californians and their ability to live long, healthy lives, and it sends the wrong message about who we are and what we value.
While Black Californians represent about 7% of the total Medi-Cal enrollees, 1,013,251of them — about 50% of the state’s total Black population — are enrolled in Medi-Cal. The budget cuts risk reinforcing the very inequities California has pledged to dismantle. And while it may promise short-term savings, the long-term costs — medical, economic, and human lives — will far overshadow them.
California has long positioned itself as a leader in public health and health equity and we cannot retreat from being that beacon now. Instead of cutting access to healthcare services and treatments like obesity medications, we should be investing in scalable, community-driven solutions that address the root causes of health disparities.
State lawmakers must protect Medi-Cal coverage and preempt the risk of escalating costs and poorer health outcomes and focus on disease prevention and progression. Effective obesity treatments can be a solution. Equity, prevention, and a long-term vision should guide our budget choices, not short-term savings that come at the cost of our most vulnerable communities.
At such a critical moment for Americans’ healthcare at both the federal and state levels, California elected officials need to do the right thing and support coverage for anti-obesity medication, and protect Medi-Cal.
About the Author
Rhonda Smith is the Executive Director of the California Black Health Network.
