Denver, Colorado – A bill that recently progressed in the Colorado State Capitol could potentially require state-regulated insurers and Medicaid to provide coverage for weight loss drugs for individuals who are either obese or prediabetic. Despite facing opposition from the Division of Insurance and the Department of Health Care Policy and Financing, the bill managed to pass the Senate Appropriations Committee.
The bill’s estimated cost implications have raised concerns, with the state’s Medicaid system potentially facing an $86 million expense in the first year alone. Additionally, an actuarial analysis by the Division of Insurance suggested that insurance premiums could increase by up to $30 million annually if the bill were implemented.
Critics of the bill, including State Sen. Jeff Bridges, expressed frustration over the lack of consideration for potential cost savings in the analyses. The oversight prompted skepticism regarding the credibility and thoroughness of the assessments conducted.
State Sens. Dafna Michaelson Jenet and Joanne Ginal, who are sponsors of the bill, emphasized the long-term health benefits that weight loss drugs could offer in preventing various chronic conditions such as kidney disease, heart disease, and cancers. They argued that the proposed coverage for medication was necessary to complement lifestyle therapy for effective treatment.
The Department of Health Care Policy and Financing advocated for insurers to prioritize covering lifestyle therapy, such as diet and exercise, over medication. However, proponents of the bill pointed out the inconsistency in excluding medication coverage for weight management while it is typically included in the treatment of other diseases.
State Sen. Julie Gonzales challenged the Department’s stance, questioning how promoting healthier lifestyles and improved healthcare access could obstruct their equity plan. The debate underscored the complex considerations surrounding healthcare coverage and resource allocation within the state.
Despite the bill’s obstacles, it was amended to take effect in January 2025 and successfully passed the committee with minimal opposition. Its progression to the full Senate remains the next crucial step in potentially reshaping the state’s approach to addressing obesity and related health concerns.