Many Marylanders struggle with obesity but cannot get access to weight loss medications because insurance will not pay for them.
A proposed bill would make the drugs available to Medicaid patients statewide.
The stumbling block is the projected cost of more than $200 million as the state deals with a budget shortfall—an estimate the sponsor of Senate Bill 876 said is “wildly inflated.”
If the legislation passes, patients would be eligible for the drugs starting in July 2026.
Testifying to state lawmakers
Nikki Massie told WJZ she has long struggled with her weight and wants access to the new class of GLP-1 semaglutide weight loss medications that right now are not covered for most Medicaid patients in Maryland.
“The reason why we hear so much about GLP-1 medications is because they work, and the reason why they’re demonized, is because of stigma,” Massie said. “People feel like you should have to work your way out of obesity, you should suffer your way out of obesity. The science just doesn’t back up that we have as much control over it for that to be warranted.”
Massie, a breast cancer survivor, said there is unwarranted stigma surrounding obesity compared to other medical conditions.
“They deserve to be able to go to their doctor, have a meaningful conversation, and have the most effective treatments available to them, and right now, that’s just not happening,” Massie said.
She testified before lawmakers Tuesday as they considered whether to advance the legislation to provide medications, including Ozempic and Wegovy.
Currently, Medicaid only covers bariatric surgeries and behavioral therapy.
“When I had breast cancer, my treatment was clear and compassionate. There was a standard path of healthcare for life and no barriers to the treatment that I needed, but when it came to treating my obesity, a disease that also affects my long-term health, there was no road map, no doctor guiding me, and no commitment to my care,” Massie told the Senate Finance Committee.
The cost
This is the second year Maryland lawmakers have considered the issue, deciding to order a study in 2024. The drugs cost almost $1,300 a person every month.
In a fiscal note, the Maryland Department of Health estimated 15% of Medicaid patients would be eligible, costing $225 million per year.
But Senator Steve Hershey, who is sponsoring the bill, said the figures for utilization numbers are too high.
He estimated only 3% of patients would be eligible and said some states see even fewer.
Preventing other illness
Senator Hershey said the medications would save money by preventing more costly illnesses, like diabetes and cancer in obese Marylanders.
“Imagine if we treated high blood pressure this way: Tell patients just eat less salt—and then waiting until they need heart surgery,” the Republican lawmaker said.
Fourteen other states currently cover the weight loss drugs, which doctors who testified Tuesday said are effective and less invasive than surgery.
“The question isn’t whether Maryland will spend more money on obesity. We already do. The question is whether we’re going to spend it wisely,” Senator Hershey testified.
Hershey said, “Obesity is not a personal failing. It is a chronic disease recognized by every major medical authority, and it is fueling a crisis in Maryland. It drives over 200 serious health conditions.”
Massie said those with obesity do not deserve the stigma and need access to what for many are life-changing medications.
“Even if you don’t care about people who live with obesity and the bias and the stigma and the quality of life that they experience, it’s just an efficient and effective way to handle things to give people the full range of treatments that are available,” she said.
Advocates said doctors would still have to determine eligibility, and the bill would not mandate coverage for everyone.
“Maryland Medicaid treats obesity differently from other chronic conditions. We cover the expensive consequences like dialysis, amputations and emergency surgeries, but we don’t cover the treatments that could prevent those outcomes in the first place,” Senator Hershey said. “What’s worse—Medicaid is permitted to treat obesity with medications, but the trick is you must survive a heart attack or stroke, and that doesn’t make sense.”