Colorado bill would require insurers and Medicaid to cover weight loss drugs like Wegovy
If you struggle with your weight -- you're not alone. More than 40% of people are considered obese. While the FDA has approved new drugs to treat obesity, most insurers won't cover them.
"We know that if this was a cure for cancer that it would absolutely be paid for," said Colorado state Sen. Dafna Michaelson Jenet, who has introduced a bill that would require insurers and Medicaid to cover the drugs for people like Adam Burtt, who weighed 300 pounds a year ago.
"I've lost 85 pounds in the last 10 months. It's crazy," he said.
Crazy impossible, he thought, until he tried Ozempic, a drug used for years to treat diabetes. It's one of several drugs -- including Wegovy, Saxenda, Mounjaro, and Zepbound -- that are showing extraordinary success in treating obesity. But it's not cheap. Ozempic runs about $1,000 a month.
Burtt says the benefits far outweigh the costs.
"You can just bend easier. Your joints feel better. Everything about your health just feels better," Burtt said.
Dr. Leigh Perreault, an endocrinologist at UCHealth, says insurers' refusal to cover drugs like Ozempic makes no sense. Obesity, she says, is not only a serious chronic progressive disease itself, it is linked to more than 200 other diseases.
"Cardiovascular disease and sleep apnea and fatty liver disease and things like malignancies - 50% of all cancers are linked to obesity - and mobility problems like the need for hip replacements, and so why would we not want to get rid of the cause? It's like treating somebody for lung cancer and not telling them to stop smoking," she said.
Perrault, who lectures around the world about obesity, says the disease is largely misunderstood.
"It is not a matter of a lack of discipline or willpower. It is the body adapted for survival. So, whenever we gain weight our body will reset our set point higher and higher and higher and then it will defend it relentlessly," she said.
That's why most people, who lose weight through diet and exercise she says, gain it all back.
Like other chronic diseases, she says, obesity too often requires lifelong drug treatment.
Medications like Ozempic, she says, are a game changer.
"We are in a whole new world. A whole new world that not only do the medications now work so much better but they are so much safer," she said.
A fiscal analysis found the bill will cost the state's Medicaid program more than $200 million a year.
Saskia Young with the Colorado Association of Health Plans says it will also cost policyholders. She says it could raise premiums as much as 20%.
"We are not weighing in to whether this is a good policy or a bad policy. Our job here really is to highlight the cost implications," said Young.
Burtt believes the savings will be higher than the costs.
"I'm going to save money in the long run by being a healthier human," Burtt said.
Perrault - who instituted a weight management process called Pathweigh in all 66 UCHealth family practice clinics - received a grant from the National Institutes of Health to study, among other things, the cost-effectiveness of weight loss drugs in combination with a healthy lifestyle.
She says the study includes 100,000 patients and is the largest ever randomized clinical trial.
Bill SB24-054 will be heard by the Senate Committee on Thursday at 1:30 p.m.
