Forty state legislators have sent a letter to the Group Insurance Commission board warning about the public health risks involved with eliminating coverage for GLP-1 weight-loss drugs for obesity — a move that they predict could drive up future hospitalizations and lead to an increase in health care costs as the health of public employees declines.
The letter follows the GIC Board of Commissioners narrow 10-7 vote on Feb. 26 to stop covering the medication for weight loss as a cost-cutting measure in the face of climbing health care expenses.
The legislators who signed the March 9 letter to the board, including Sen. Adam Gomez, D-Springfield, Rep. Homar Gómez, D-Easthampton, and Rep. Lindsay Sabadosa, D-Northampton, agree that cutting off access to a preventative medication is an ineffective solution to the fiscal pressure from federal cuts to health care.
“We should not set a precedent where medical proven treatments are eliminated solely because of the short-term budget pressures,” Gomez said.
The GIC is a quasi-independent health insurance agency that provides benefits for more than 460,000 public employees and retirees. Margaret Anshutz, the agency’s director of health policy and analytics, told Statehouse News Service that around 22,000 members use GLP-1, which costs the commission $46 million.
Its many of these constitutes who sent Homar Gómez and Sabadosa email after email expressing distress over losing access to a medication that has greatly benefited their overall health.
“People are using the medication and now thanks to that medication, they don’t have to use other types of medications for conditions like blood pressure, [Type-2] diabetes, you name it,” Homar Gómez said.
In the two-page letter, legislators argue that cutting coverage will force state and municipal employees to choose between a “life-altering, sometimes life-saving” treatment and other essential expenses.
Studies have shown that after stopping treatment, the weight quickly comes back and increases the risk of other chronic illnesses such as heart disease, high blood pressure and Type 2 diabetes. While money will be save in the short-term, future budget seasons may be plauged with higher rates of hospitalizations, disability and chronic illness treatment, they said.
Legislator are asking the GIC board to revisit the issue by monitoring GLP-1 prices, evaluating the true cost-savings with long-term impacts and setting a clear timeline to reinstate coverage of these medications.
“We have a federal government that is rolling back public health for communities,” Sabadosa said. “There should be a public health response to addressing them and GLP-1 is one part of the solution. They [GLP-1] have had a proven benefit, and when you see that, you don’t remove that benefit. You find a way to make is accessible.”
GIC is the most recent health insurance company to cease covering GLP-1 drugs for obesity, following in the footsteps of commercial and public insurance companies like the Hampshire Country Group Insurance Trust and the Massachusetts Interlocal Insurance Association. Insurance companies like the GIC still cover GLP-1 for other conditions like Type 2 diabetes.
The Massachusetts Teachers Association last month held a rally and panel at the University of Massachusetts Amherst campus discouraging removal of GLP-1 coverage and increases in monthly premiums and deductibles. Gov. Maura Healey asked the GIC to “seriously consider” any changes to weight-loss drug coverage.
In anticipation of a 10% budget increase in fiscal year 2027, the GIC has approved an average 7.5% increase in premiums to take effect next fiscal year, which begins July 1. The increase is lower than the estimated rage of a 9% to 13% hike, largely credited to the elimination of GLP-1 coverage.
The state will infuse $300 million into the GIC to help the agency continue to cover costs after April, but Healey has requested the agency control its rising costs by finding $120 million in savings. Both Adam Gómez and Homar Gómez said the health insurance agency should focus on providing coverage to commonwealth employees, and the Legislature should focus on balancing the budget.
The World Health Organization, American Medical Association and Center for Disease Control and Prevention considers obesity a complex chronic disease. Nearly 40% of adults in the United States suffered from obesity in 2023, according to the Obesity Medical Association. Most recently, a study published in November 2024 found that the mortality rate for individuals with ischemic heart disease related to obesity tripled from 1999 to 2020. Black adults, middle-aged men and people living in rural areas saw a higher risk.
“It’s not about cosmetic weight loss, it’s about managing a chronic disease,” Sen. Adam Gómez said.
According to the legislator’s letter, the cost of GLP-1 injections without insurance ranges from $450 for generic medications to over $1,000 for name brands like Wegovy. The Trump administration struck a deal with pharmaceutical companies Eli Lilly and Novo Nordisk last month to lower the cost the GLP-1 to $149 for a starter dose of the pill. Companies like TrumpRx can provide coupons for these medications, but these are out-of-pocket costs.
“I think with that political pressure and the insurance companies saying it’s too expensive, you’re going to start seeing the biomedical industry respond and make it less expensive,” Sabadosa said. “Right now, the policy question is how do we continue to provide coverage as the market is changing and as new medications are introduced, and how do we use legislative pressure to continue coverage for our constitutes.”