Colorado lawmakers light up state agencies opposed to paying for weight loss drugs: 'Perhaps it's time they go on a diet'

A bill that would require state-regulated insurers and Medicaid to cover weight loss drugs for people who are obese or prediabetic cleared a major hurdle at the Colorado State Capitol. The bill passed the Senate Appropriations Committee despite opposition from the Division of Insurance and Department of Health Care Policy and Financing. Both insist the measure is cost-prohibitive.

According to legislative fiscal analysts it would cost the state Medicaid system $86 million the first year alone. An actuarial analysis by the Division of Insurance found it could also raise insurance premiums by as much as $30 million a year.

But neither study looked at potential cost savings, and that didn't sit so well with some members of the Appropriations Committee, including the Chair, state Sen. Jeff Bridges.

"I can't believe an actuarial study that was performed by state at the direction of a bill passed by general assembly, didn't include cost savings," he said.

Bridges stopped short of accusing the Division of Insurance of violating state law, which requires actuarial reviews include both the potential costs and cost savings.

"Unfortunately we don't have the facts about potential savings because they just decided not to look into that. I'm extraordinarily upset about that," he said.

So are state Sen. Dafna Michaelson Jenet and state Sen. Joanne Ginal, sponsors of the bill.

"Utilizing these drugs can help in long run with chronic kidney disease, with heart disease, to prevent stroke, cancers, so many other diseases," said Ginal.

Michaelson Jenet says the analyses were inflated to kill the bill.

"I got the fiscal note and said, 'Okay, there's something fishy here,'" she said.

The Department of Health Care Policy and Financing insists insurers should only have to cover lifestyle therapy like diet and exercise.

Michaelson Jenet noted there is no other disease for which lifestyle therapy only -- and not medication -- is covered.

"If we want look at the definition of insanity -- doing something over and over again and expecting different results -- that's what that is," she said.

The Department also argued coverage for medication would interfere with its equity plan.

State Sen. Julie Gonzales said that makes no sense.

"Allowing people to live healthier and fuller lives is somehow going to interfere with their equity plan? I invite the Department to figure it out and try harder."

State Sen. Barb Kirkmeyer noted the state gives the Department $5 billion a year, more than it spends.

"The reality is they will also be having underutilized general fund monies that will be able cover this in January of 2025," she said.

Gonzalez had a better idea.

"Perhaps it's time they go on a diet," she said.

The bill was amended to take effect in January of 2025 and passed the committee with only vote in opposition. It needs to pass the full Senate before going to the House.