Legislators Target State Agencies Hostile to Weight-loss Drug Funding

A proposed law that would make it mandatory for insurance companies and Medicaid to pay for weight loss medications for individuals who are obese or at risk of developing diabetes has passed an important step in the Colorado State Capitol. The bill was approved by the Senate Appropriations Committee, even though the Division of Insurance and Department of Health Care Policy and Financing were against it. Both people argue that the measure is too expensive.

Legislative fiscal analysts have estimated that the state Medicaid system would need to spend $86 million in the first year alone. A study by the Division of Insurance showed that insurance premiums could increase by up to $30 million per year.

However, both studies did not examine possible ways to save money, which was a concern for some members of the Appropriations Committee, including the Chair, state Sen. Jeff Bridges.

“I can’t believe that a study done by the state, as directed by a bill passed by the general assembly, did not include any cost savings,” he said. Bridges did not directly accuse the Division of Insurance of breaking state law. State law mandates that actuarial reviews must consider both the potential costs and cost savings.

“We don’t have information about potential savings because they chose not to investigate that.” “I’m really upset about that,” he said. State Sen. Dafna Michaelson Jenet and state Sen. Joanne Ginal are the sponsors of the bill. “Using these drugs can be beneficial in the long term for conditions like chronic kidney disease, heart disease, stroke prevention, and even certain types of cancer,” Ginal explained.

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Michaelson Jenet claims that the analyses were exaggerated in order to prevent the bill from passing. “I received the fiscal note and thought, ‘Hmm, something seems suspicious here,'” she said. The Department of Health Care Policy and Financing believes that insurers should only be required to cover lifestyle therapy, such as diet and exercise.

Michaelson Jenet pointed out that lifestyle therapy is the only treatment covered for this disease, without the need for medication. “If we want to understand the definition of insanity, it means doing something repeatedly and hoping for different outcomes,” she explained.

The Department also stated that providing coverage for medication would disrupt its equity plan. State Senator Julie Gonzales expressed her confusion, stating that it doesn’t make any sense.

“Is it possible that promoting healthier and more fulfilling lives for people will somehow conflict with their equity plan?” I encourage the Department to find a solution and put in more effort.

State Senator Barb Kirkmeyer pointed out that the state provides the Department with $5 billion annually, which is more than what the Department actually spends.

“She said that in January of 2025, they will have extra money from the general fund that is not being used much, which can be used to cover this expense,” she said.

Gonzalez came up with a better idea. “Maybe it’s time for them to start a diet,” she said. The bill was changed to start in January of 2025 and was approved by the committee with only one vote against it. The bill must be approved by the entire Senate before it can be considered by the House of Representatives.