Colorado Legislators Push for Weight Loss Drug Funding

TL/DR –

A bill requiring Colorado insurers and Medicaid to cover weight loss drugs for prediabetic or obese patients passed the Senate Appropriations Committee, despite opposition from the Division of Insurance and Department of Health Care Policy and Financing. The bill’s opponents argue it would cost the Colorado Medicaid system $86 million in its first year, potentially raising insurance premiums by $30 million annually. Supporters of the bill, including state senators Dafna Michaelson Jenet and Joanne Ginal, argue the bill would result in long-term health benefits and cost savings which were not considered in the cost analyses.

Colorado Bill Mandating Insurance Coverage for Weight Loss Medications Overcomes Major Obstacle

A Colorado bill requiring state-regulated insurers and Medicaid to cover obesity and prediabetes treatment drugs passed the Senate Appropriations Committee, despite strong opposition from the Division of Insurance and Department of Health Care Policy and Financing, who argue it is too expensive.

The legislation is anticipated to cost the state Medicaid system $86 million during its first operational year. Additionally, an actuarial analysis by the Division of Insurance predicts an annual insurance premium increase of up to $30 million.

Critics Question Lack of Cost Savings Analysis

However, some senators, including the Chair of the Appropriations Committee, Jeff Bridges, voiced their dissatisfaction with the lack of cost savings considerations in these studies. Bridges criticized the Division of Insurance for not complying with a state law requiring actuarial reviews to assess both the potential costs and savings.

State Senators Dafna Michaelson Jenet and Joanne Ginal, the bill’s sponsors, also expressed their concerns. Ginal stressed that the use of these drugs could help prevent chronic diseases, such as kidney and heart disease, strokes, and cancers, leading to long-term savings.

Debate Over Lifestyle Therapy vs Medication Coverage

The Department of Health Care Policy and Financing maintains that insurers should only cover lifestyle therapy such as diet and exercise. Michaelson Jenet countered this stance, arguing that no other disease has coverage restricted to lifestyle therapies only. The Department also claimed that medication coverage would disrupt its equity plan, a claim disputed by State Senator Julie Gonzales.

Bill Amended and Passed Committee

The controversial bill was amended to take effect in January 2025 and was approved by the committee with just one opposing vote. It now needs to pass the full Senate before proceeding to the House.

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