Bill requiring state-regulated insurance companies and Medicaid Covers weight loss drugs for people who are obese or prediabetic A major hurdle has been cleared at the Colorado State Capitol. The bill passed the Senate Appropriations Committee despite opposition from the Department of Health and the Department of Health Policy and Finance. Both argue that the measure would be prohibitively expensive.
Legislative financial analysts say the state’s Medicaid system would cost $86 million in the first year alone. An actuarial analysis by the Department of Insurance found that premiums could rise by up to $30 million a year.
But neither study looked at potential cost savings, something that some members of the Appropriations Committee, including the committee chairman, State Sen. Jeff Bridges, were not happy about.
“I find it hard to believe that cost savings were not included in the actuarial studies conducted by the state at the direction of the bill passed by the General Assembly,” he said.
Bridges came close to accusing the insurance department of violating state law requiring actuarial reviews to include both potential costs and savings.
“Unfortunately, they just decided not to look into it, so there are no facts about potential savings. I’m very upset about that,” he said.
So do the bill’s sponsors, state Sen. Daphna Michelson Jennette and state Sen. Joan Zinal.
“These drugs can help prevent many diseases in the long term, including chronic kidney disease, heart disease, stroke and cancer,” Zinal said.
Michelson-Gennett claims the analysis was inflated to invalidate the bill.
“I got my accounting notebook and said, ‘Okay, there’s something fishy here,'” she said.
The Ministry of Health Policy and Finance insists that insurance companies should only cover lifestyle treatments such as diet and exercise.
Michelson-Gennett pointed out that there is no other disease for which only lifestyle therapy, rather than medication, is the target.
“Let’s look at the definition of insanity: doing something over and over again and expecting a different result, that’s it,” she said.
The ministry also argued that insurance coverage for drugs would interfere with capital planning.
State Sen. Julie Gonzalez said that doesn’t make sense.
“Is enabling people to live healthier, more fulfilling lives somehow going to undermine capital planning? I encourage the Department to understand that and do more.”
State Sen. Barb Kirkmeyer noted that the state provides $5 billion a year to the department, more than it spends.
“The reality is that in January 2025, we won’t even have enough General Fund money to cover this,” she said.
Gonzalez had a better idea.
“Maybe it’s time for them to go on a diet,” she said.
The bill was amended to take effect in January 2025 and passed out of committee with only a negative vote. It must pass the full Senate before being sent to the House.
