Taxpayers need to know how heavy a toll they'll be paying for weight-loss drug coverage

Expanding insurance coverage of high-priced injectable weight-loss drugs for state workers will cost taxpayers $210 million in the first year of the initiative. But at least one economist says that estimate is way off and is expected to be millions more.

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Ozempic

The injectable drug Ozempic is shown Saturday, July 1, 2023, in Houston. Starting July 1, Ozempic and other weight-loss drugs like Wegovy and Mounjaro will be covered for state employees in Illinois.

David J. Phillip/AP

The country’s obesity rates have been scaling up over the past two decades. Nearly 42% percent of adults in the U.S. qualified as obese in 2023, data collected by nonprofit Trust for America’s Health show.

Children haven’t been faring much better. Roughly 20% of boys and girls ages 2 to 19 were obese between 2017 and 2020, according to the U.S. Centers for Disease Control and Prevention.

The numbers for Black and Hispanic populations are even worse, due to a lack of nutritious food options, poor access to health care and other structural barriers.

Gov. J.B. Pritzker’s administration didn’t specify disparities among communities of color but cited “equity” as the goal for expanding insurance coverage of high-priced injectable weight-loss drugs for state workers.

By ensuring all nine health insurance carriers involved in the state health program cover medications like Wegovy, Mounjaro and Ozempic, more people will have a chance to eliminate long-term health problems, staffers with the governor’s office said.

Editorial

Editorial

The initiative is estimated to cost taxpayers $210 million the first year, although Pritzker spokesperson Jordan Abudayyeh said the price tag could end up being less.

Economist Ryan Cummings isn’t as optimistic. Cummings told WBEZ reporter Dave McKinney that Illinois could be on the hook for $300 million to more than $461 million if half of the eligible state workers partake in coverage.

None of those figures is chump change.

Exercise and eating right are always the best strategies to shed pounds. But any proactive policy designed to combat obesity and along with diabetes, heart disease and other illnesses tied to excessive weight can be additionally beneficial.

And there is a possibility, no matter the expense, coverage for weight loss drugs for state employees could be cheaper in the long run.

Obesity-related medical care costs in the U.S. hovered around $173 billion in 2019, according to the CDC.

The provision for the expanded coverage for weight-loss drugs was slipped into a 899-page budget bill that was approved by the Illinois General Assembly last May, so some legislators didn’t know about it until McKinney alerted them. The onus is on elected lawmakers to read proposed legislation they are voting on.

But questions surrounding transparency are valid as it is unclear who green-lighted the four sentences in the bill that called for the broadened coverage.

The Pritzker administration needs to lay out the exact math for how much taxpayers will have to shell out for the weight-loss drugs as soon as it can. Or explain further why its estimate is more accurate than the other. Taxpayers deserve to know the final price of what they’re paying for.

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