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For employers operating on tight benefit budgets, that’s an untenable increase to absorb — especially when utilization consistently came in higher than projected. In conversations documented by the Kaiser Family Foundation and Peterson Center on Healthcare, employers described trying multiple cost-management strategies — step therapy requirements, prior authorization, weight-loss program prerequisites — before ultimately concluding that no guardrail was controlling the spend fast enough. Importantly, the law doesn’t require employers to offer GLP-1 coverage