HARRISBURG (TNS) — After adding more than $1 billion to its anticipated Medicaid costs this year specifically for Ozempic and similar weight-loss drugs, the state Department of Human Services wants to curtail their taxpayer-funded use for obesity — but not for diabetes.
Dr. Valerie Arkoosh, state secretary of human services, testified at a budget hearing in the Capitol on Tuesday about the exploding government cost associated with Ozempic and other “GLP-1” medications. Other topics included potential cuts to federal human services programs, and Arkoosh said a proposal for a major reduction in SNAP benefits would be an “enormous” loss for Pennsylvania.
Human Services’ proposed budget of $21.2 billion is the single biggest piece of Gov. Josh Shapiro’s proposed 2025-26 spending plan of $51.5 billion.
The department’s figure is an increase of nearly $2 billion from the current year’s budget. A big driver of the proposed increase is Medicaid benefits, and within that category are the weight-loss drugs.
Arkoosh said the expensive medicines are relatively new and hence there is little historical data on them.
“The prescribing of these drugs just rose dramatically. Far faster than, I think, anyone anticipated,” she said.
The drugs have a proven record of reducing system costs when prescribed for people with diabetes, she said. However, there is no similar existing record that they reduce system costs when prescribed solely for obesity, she said.
“We are taking a very hard look at how we are using these medications for obesity,” she said.
The department plans to propose “a much more robust prior authorization” for the drugs in obesity situations, she said. The requirements would involve body-mass index levels and proof that the patient has already tried a series of other measures, Arkoosh said.
The end result, she said, would be taxpayer-funded use of the drugs only in “almost extreme situations” of obesity.
When the discussion turned to a new federal budget proposal for a $230 billion reduction in SNAP benefits over a 10-year period, Arkoosh said the loss to Pennsylvania would be “enormous” if the program ended.
The federally funded program funnels $367 million into the state each month, she said, and is “all money that goes directly to individuals to purchase food.” Separately, she said the administration of the program costs the state about $200 million a year.
More than two million people receive the benefits, which depending on eligibility range from $23 a month to $300 to $350 a month, she said.
On the potential loss of the federal money, Arkoosh said, “There would be no way that we could make up for that funding with state dollars. Nor could the charitable food network.” She noted that charitable food programs provide one meal for every nine covered by SNAP.
