Budget Amendment ID: FY2027-S4-492-R1

Redraft EHS 492

GLP-1 Coverage Loss Study

Ms. Friedman, Ms. Rausch, Messrs. Payano and O'Connor, Ms. Edwards, Ms. Lovely and Mr. Tarr moved that the proposed new text be amended in section 2, in item 1108-5100, by striking out the following words:- “and provided further, that not later than February 5, 2027, the commission shall submit a report to the joint committee on health care financing and the house and senate committees on ways and means detailing: (a) the impact of the elimination of coverage of glucagon-like peptide-1 medications for obesity management on subscriber finances and health; (b) the annualized cost savings associated with the elimination of coverage; and (c) short- and long-term strategies for limiting the cost growth of high-cost medications including, but not limited to, glucagon-like peptide-1 medications”; and

in said section 2, in item 1108-5100, by adding the following words:- “provided further, that not less than $300,000 shall be expended to the Harvard T.H. Chan School of Public Health to conduct a study and issue a report on the impact of discontinuing commercial and public health insurance coverage for glucagon-like peptide-1 medications for patients with obesity on health status and health care utilization; provided further, that such funds shall be made available until June 30, 2029; provided further, that the report shall be submitted to the executive office for administration and finance, the joint committee on health care financing and the house and senate committees on ways and means and shall include, but not be limited to, an analysis of: (a) the impacts of discontinued coverage for glucagon-like peptide-1 medications on health care services utilization, total medical spending and enrollee out-of-pocket spending; (b) how individuals and providers respond to discontinued coverage of glucagon-like peptide-1 medications including, but not limited to, paying for the medication out of pocket or recoding patient diagnoses; (c) how the impacts vary across groups of individuals; and (d) the comparison of health outcomes and total medical spending between enrollees that have lost coverage of glucagon-like peptide-1 medications and enrollees who have maintained coverage for glucagon-like peptide-1 medications for obesity management; and provided further, that not later than February 7, 2027, the commission shall submit a report to the executive office for administration and finance, the joint committee on health care financing and the house and senate committees on ways and means detailing the preliminary findings of the study”; and by striking out the figure “$5,824,752” and in inserting in place thereof the following figure:- “$6,124,752”.