Maine lawmaker wants MaineCare to cover Ozempic and other weight loss drugs
Mar. 4—The Maine Legislature is considering a bill that would require MaineCare to cover popular weight loss drugs like Ozempic.
The proposal went before the Health and Human Services Committee for a public hearing on Tuesday.
Ozempic and other similar drugs such as Wegovy and Zepbound can help people lose weight by controlling appetite and reducing cravings.
But the drugs can be pricey, with 30-day prescriptions typically around $1,000 to $1,500. The cost is causing some private insurance to exclude them from coverage in their policies, although that practice has also resulted in lawsuits, including two in Maine.
Despite the cost, the drugs are popular, and according to a 2024 KFF poll, one in eight adult Americans have taken the Ozempic class of medications.
Ozempic and similar drugs were originally approved by the Food and Drug Administration as diabetes medicine, but they have also been found to help control weight. However, of the adults taking the drugs, about 40% are using the medications to treat diabetes, 22% were taking them primarily for weight loss, and the remaining for other reasons.
Anne Graham, D-North Yarmouth, a retired nurse practitioner, and the primary sponsor of the bill, L.D. 480, said MaineCare should cover the popular weight loss medications because patients should have access to all available tools to help them be healthier.
"Everyone should have access to obesity treatment, including these weight loss medications," Graham said.
Thirteen states — including New England states Massachusetts, Connecticut and Rhode Island — have approved the Ozempic class medications for their Medicaid programs. MaineCare is the state's name for Medicaid, which is a federal program operated by the states funded with a mix of federal and state dollars.
Dr. Allen Browne, of Falmouth, a retired pediatric surgeon, testified in favor of the bill, and said it is "wrong" to tell patients that a drug "exists, is safe and effective, but it's not available due to the cost."
Browne said some health care providers will not even mention the weight loss medications to their patients, knowing that it's too pricey for their patients to afford.
But Courtney Pladsen, MaineCare's medical director, testified against the bill, arguing that it would simply be too costly.
"Our conclusion is that the cost of adding this coverage would be prohibitive," said Pladsen, who pointed out that children in the MaineCare program can currently be prescribed Ozempic or similar drugs, but that the drugs are not available in MaineCare to adults.
Pladsen said that adding the medications would cost MaineCare $42 million in 2026 and $53 million in 2027.
"Requiring MaineCare to cover (these drugs) for treating obesity would have a significant fiscal impact. This is untenable given MaineCare's current budget shortfall," Pladsen said.
MaineCare is currently facing an $118 million shortfall in the current fiscal year. Under Gov. Janet Mills' budget proposal, a number of controversial cutbacks would be made to stabilize the MaineCare budget, including eliminating a cost-of-living increase for direct care workers and reductions of stipends for child care workers.
Mills' overall $11.6 billion biennium budget calls for some cutbacks, but also raises revenue with a cigarette tax increase from $1 to $3 per pack, and a 40% increase in the adult use cannabis sales tax, to 14%.
Copy the Story Link
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
42 minutes ago
- Yahoo
RFK Jr ousts entire US vaccine panel over alleged conflicts
US Health Secretary Robert F. Kennedy Jr. on Monday announced he was dismissing all current members of a key federal vaccine advisory panel, accusing them of conflicts of interest -- his latest salvo against the nation's immunization policies. The removal of all 17 experts of the Advisory Committee on Immunization Practices (ACIP) was revealed in a Wall Street Journal op-ed and an official press release. Kennedy, who has spent two decades promoting vaccine misinformation, cast the move as essential to restoring public trust, claiming the committee had been compromised by financial ties to pharmaceutical companies. "Today we are prioritizing the restoration of public trust above any specific pro- or anti-vaccine agenda," he said in a statement from the Department of Health and Human Services. "The public must know that unbiased science -- evaluated through a transparent process and insulated from conflicts of interest — guides the recommendations of our health agencies." In his op-ed, Kennedy claimed the panel was "plagued with persistent conflicts of interest" and had become "little more than a rubber stamp for any vaccine." He added that new members were being considered to replace those ousted -- all of whom were appointed under former president Joe Biden. ACIP members are chosen for their recognized expertise and are required to disclose potential conflicts of interest. "RFK Jr. and the Trump administration are taking a wrecking ball to the programs that keep Americans safe and healthy," Senate Democratic Leader Chuck Schumer said in response. "Of course, now the fear is that the ACIP will be filled up with people who know nothing about vaccines except suspicion," Republican Senator Bill Cassidy, a medical doctor who expressed concern about Kennedy's track record during his Senate nomination but ultimately voted in his favor, wrote on X. "I've just spoken with Secretary Kennedy, and I'll continue to talk with him to ensure this is not the case." - 'Silencing expertise' - The decision drew sharp criticism from Paul Offit, a pediatrician and leading expert on virology and immunology who served on the panel from 1998 to 2003. "He believes that anybody who speaks well of vaccines, or recommends vaccines, must be deeply in the pocket of industry," Offit told AFP. "He's fixing a problem that doesn't exist." "We are witnessing an escalating effort by the Administration to silence independent medical expertise and stoke distrust in lifesaving vaccines," added Susan Kressly, president of the American Academy of Pediatrics, in a statement. Once a celebrated environmental lawyer, Kennedy pivoted from the mid-2000s to public health -- chairing a nonprofit that discouraged routine childhood immunizations and amplified false claims, including the long-debunked theory that the Measles, Mumps and Rubella (MMR) vaccine causes autism. Since taking office, he has curtailed access to Covid-19 shots and continued to raise fears around the MMR vaccine -- even as the United States faces its worst measles outbreak in years, with three reported deaths and more than 1,100 confirmed cases. Experts warn the true case count is likely far higher. "How can this country have confidence that the people RFK Jr. wants on the Advisory Committee for Immunization Practices are people we can trust?" Offit asked. He recalled that during US President Donald Trump's first term, several states formed independent vaccine advisory panels after the administration pressured federal health agencies to prematurely approve Covid-19 vaccines ahead of the 2020 election. That kind of fragmentation, Offit warned, could happen again. ACIP is scheduled to hold its next meeting at the headquarters of the Centers for Disease Control and Prevention in Atlanta from June 25 to June 27. Vaccines for anthrax, Covid-19, human papillomavirus, influenza, Lyme disease, respiratory syncytial virus, and more are on the agenda. ia/jgc
Yahoo
42 minutes ago
- Yahoo
700 Rhode Islanders to lose Medicaid coverage; state blames old mistake
PROVIDENCE, R.I. (WPRI) — While Democrats are fighting proposed Medicaid cuts at the federal level, Rhode Islanders are facing their own cuts on the state level due to a change in the program's income limit. 'I think the only reason that a state would be motivated to do that is to save money,' said Sam Salganik, executive director of RIPIN, a nonprofit that helps people navigate the health care system. Salganik said the state used to have an income limit of about $19 an hour for a single parent of two. But he said the state is now lowering that to roughly $18.30. REPORT: 366K+ Rhode Islanders would be impacted by proposed Medicaid cuts A spokesperson for the state's Executive Office of Health and Human Services (EOHHS) said 700 parents and caretakers will lose Medicaid coverage because of the new income limit, which was put in place due to a mistake made years ago. According to the state agency, it will take effect for new patients beginning this month. 'If [the U.S. Centers for Medicare and Medicaid Services (CMS)] has not approved the state to spend federal Medicaid money for a certain group at a certain income level, the state is not allowed to do so,' spokesperson Kerri White wrote. But Salganik said the federal income limit is the floor, not the ceiling. 'States always have the flexibility to have higher income limits than the minimums that were established by the Affordable Care Act, as long as it's part of the approved state Medicaid plan,' he explained. 'And this has been part of the approved state Medicaid plan for many, many years.' Salganik is also concerned this is being done through agency regulations rather than the legislative budget process. 'This is an example of why administrative departments need to do the fundamental things right the first time,' House Speaker Joe Shekarchi wrote in a statement to 12 News. 'Errors like these have real consequences.' MORE: Suspected Medicaid fraud in RI sparks criminal probe, proposed changes EOHHS said affected Medicaid recipients will be sent a letter, but they'll be able to keep their benefits until their annual renewal, or until a quarterly post-eligibility verification process. White said the change will save $1.9 million in state funds and $4.5 million when federal money is included. And while EOHHS said people will be able to buy coverage through HealthSource RI, Salgank said that will still cost low-income parents hundreds of dollars each year, if not more. 'It's just one more cost that is really difficult for them to afford,' he said. Download the and apps to get breaking news and weather alerts. Watch or with the new . Follow us on social media: Close Thanks for signing up! Watch for us in your inbox. Subscribe Now Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
an hour ago
- Yahoo
Valley Health steps up commitment to mental health service with construction of new $20M facility in Winchester
WINCHESTER, Va. () — Valley Health is looking to step up its commitment to helping those with mental health disorders in the community. Winchester-based Valley Health said that a quarter-million Americans suffer from mental illnesses such as depression or anxiety. But fewer than a quarter of people who need treatment will seek it. Frederick County technology center addresses skilled trades need Jenny Grooms is leading a fundraising drive for a mental health pavilion at Valley Medical Center in Winchester. 'Everyone has a story about a mental health challenge. Everyone. Themselves or they know someone that has been affected by a mental health or substance use disorder,' Grooms said. Tonya Smith is the chief operating officer of Valley Health System with six hospitals in Virginia and West Virginia, serving a half-million residents in 18 counties. The Winchester medical system is Valley Health's flagship operation. 'We do a community needs assessment, and every year the assessment shows mental health comes up as a gap,' Smith explains. A trip to the emergency room or a consultation with a physician is just the beginning of a process for those experiencing a mental health disorder, Smith said. 'More is needed,' Smith said. 'We need somewhere to send patients when they first come in with a crisis. That's how we started designing our mental health, behavioral health pavilion.' Martinsburg mayor delivers State of the City Address Valley Health hopes its approach can be a model for other regions across the country. 'Mental health care has been a longstanding need for many communities, especially here in the Shenandoah Valley,' Grooms said. The pavilion is set to open late in the summer of 2026. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
