Quoting his father’s views about medical injustice, Martin Luther King III on Wednesday cautioned that the state’s decisions to stop covering GLP-1 drugs for weight loss across two major insurance programs could fuel deeper healthcare disparities.
“My father once said, 'Of all the forms of inequality, injustice in health is the most shocking and the most inhumane,'” King said at a Beacon Hill briefing. “His words ask us to look beyond the existence of a medical breakthrough. They ask us to consider whether it reaches the people who need it, and they ask us to listen.”
MassHealth dropped GLP-1 weight loss drug coverage in the fiscal 2027 budget, as the Healey administration eyed ways to trim spiraling coverage costs related to the drugs. In a divided vote in February, the Group Insurance Commission board also approved nixing GLP-1 weight loss coverage, even as some state health plan overseers said the move would exacerbate health disparities and trigger sharper costs in the long term should enrollees’ chronic conditions worsen.
The decisions, echoing changes from commercial insurers and plans offered through the Massachusetts Health Connector, reflected surging healthcare cost pressures that are straining state coffers and ratcheting up premiums.
“What we’re seeing with these incredible medications is that they actually save lives, and that they treat so many comorbidities that are underlying the issue of obesity,” Rep. Marjorie Decker said. “And we walked away because we didn’t treat it as a healthcare issue. We treated it as a place to go and actually save money. It became a financial issue. And when the bean counters start driving healthcare policies, equity will never be baked in. And that’s what happened here.”
Decker, the co-chair of the Public Health Committee, insisted that “Massachusetts has a chance to turn that around” and “actually recognize mistakes we’ve made.”
During the fiscal 2027 budget process earlier this year, GIC Executive Director Matt Veno said the Healey administration had instructed the agency to cut spending by $120 million. At the time, 22,000 GIC members were taking GLP-1 drugs for weight loss, at a total cost of $46 million.
Former GIC Commissioner Darren Ambler had asked his colleagues to consider taxpayer fairness when weighing several plan changes, saying “Most taxpayers in this state, the vast, vast majority, do not have a plan that is nearly as rich as the plan that is offered by the state through the GIC.”
King, a human rights activist, described obesity as a “serious chronic disease” that disproportionately affects people of color and low-income individuals. While King acknowledged rising healthcare costs and limited public resources, he implored policymakers to consider the implications of restricting access to breakthrough treatments.
A treatment’s ability to improve health and quality of life “does not mean much to someone who cannot access it,” King said.
“A person with the means to pay out of pocket may have one set of options. A person relying on public coverage may have another,” he continued. “When that happens, we risk creating two standards of care: One for those with financial means, and another for those without. That is a health equity issue.”
Health and Human Services Secretary Kiame Mahaniah told the News Service in March he expected coverage could be restored in a few years once there’s a price crash for GLP-1 drugs. Kelley Gregorovic, an obesity management specialist, said Wednesday that GLP-1 prices are “coming down.”
“And there are savings opportunities that the state could take advantage of if they chose to,” Gregorovic said. “We cannot continue to let patients suffer because we’ve decided that their chronic condition isn’t worth fitting into the budget.”
President Donald Trump last November announced GLP-1 pricing deals with pharmaceutical manufacturers as part of his TrumpRx platform. He said the monthly costs for Ozempic and Wegovy would drop from $1,000 and $1,350 to $350 when bought on TrumpRx. Trump said the Medicare prices for Ozempic, Wegovy, Mounjaro and Zepbound would be $245.
In a recent report, the Health Policy Commission said GLP-1 spending in Massachusetts “would decrease significantly” if plans paid federally negotiated prices or international reference prices.
Starting on Jan. 1, Novo Nordisk has said it will lower the list price of Wegovy and Ozempic to $675, with the aim of reducing “access barriers, especially for patients whose out-of-pocket costs are tied to the list price.” The company said the drop would not affect “direct-to-consumer self-pay prices.”
The obesity medication landscape is also evolving. Patients can now take federally approved oral GLP-1 drugs, which offer cheaper out-of-pocket costs compared to the injectable forms, according to Yale Medicine.
Decker, asked how MassHealth and the GIC could restore GLP-1 coverage while navigating budget constraints, said there needs to be a discussion about how the state chose to target GLP-1 drugs as a cost-saving strategy.
“I would say secondly, we need to bring patients and providers as a part of that conversation. We went from coverage to nothing. There’s a whole lot of in-between that should have been explored,” Decker said, as she invoked the Executive Office for Administration and Finance. “But when A&F is calling the shots and not providers and patient advocates, we went from full coverage to nothing.”
Alternative options, Decker said, could have involved charging higher copays for GLP-1 drugs or basing eligibility on the “continuum of obesity and comorbidities” that warrant treatment.
“The GIC can bring everybody back to the table and have a more thoughtful conversation,” the Cambridge Democrat said. “There was zero planning and thoughtfulness that centered patient care, healthcare and preventative care in this. It was really a panicked reaction.”
The GIC, which provides insurance for more than 460,000 public employees and retirees, received a $300 million emergency infusion this year partly driven by exploding GLP-1 costs.
