Connecticut plans to restrict weight loss drug coverage

Connecticut is considering changes to its Medicaid program that could limit coverage for weight loss drugs, which are becoming increasingly expensive. These medications, known as GLP-1s, are effective but can cost up to $1,000 a month without insurance. Advocates argue that cutting access could lead to higher long-term health care costs from obesity-related diseases. One resident, Sarah Makowicki, struggled with severe obesity and needed a knee replacement. After surgery, she was unable to lose enough weight until her doctor prescribed Mounjaro, a GLP-1. Thanks to the medication, she lost 145 pounds and qualified for her knee surgery, allowing her to live pain-free. Connecticut’s Medicaid program spent $85 million on GLP-1s in the last fiscal year. With rising costs, state officials are proposing to stop covering these drugs for patients whose only condition is obesity. This decision could leave many patients without effective treatment options. While those with conditions like type 2 diabetes may still be covered, others would face challenges finding alternatives. Critics of the policy believe it discriminates against people with obesity and may ultimately increase healthcare costs. They emphasize the long-term health benefits and potential savings from providing access to these drugs. Advocates are fighting to maintain coverage for everyone who benefits from GLP-1s. Changes in the state’s Medicaid coverage guidelines are seen as a response to budgetary pressures, as Connecticut faces significant deficits in its Medicaid program. Lawmakers are exploring ways to ensure access to effective weight loss medications while managing costs. Meanwhile, the Connecticut state employee health plan covers GLP-1s but only through an integrated care program that aims to control expenses. Participants see health professionals and receive support to achieve their weight loss goals. As discussions continue, many, including Makowicki, are committed to advocating for policies that support access to these important treatments.