BOSTON — The state’s top health official expects coverage for GLP-1 weight-loss drugs could return in a few years once astronomical costs fall, reversing the current trend of commercial insurers and state agencies nixing the benefit.
As open enrollment launches at the Group Insurance Commission, thousands of state employees and retirees will no longer be covered for GLP-1 drugs for weight loss in a bid to save the cash-strapped agency about $46 million annually. Gov. Maura Healey’s fiscal year 2027 budget for MassHealth also calls for scrapping GLP-1 coverage for weight loss.
“I’d be really surprised if, within two years, we don’t see a major price crash in terms of how much GLP-1s cost,” Health and Human Services Secretary Kiame Mahaniah said. He added, “If I were predicting, I would say that within two to three years, we’ll be back to full coverage.”
When asked whether that restoration would likely apply to just MassHealth and the GIC, Mahaniah said, “I think for everybody.”
While health care experts have regularly touted the effectiveness of GLP-1 drugs in tackling obesity and related cardiovascular problems, their staggering cost has triggered a surge in spending and forced insurance carriers to make tough decisions. The GIC needed an emergency funding infusion last year from the Legislature partly due to the heightened popularity of GLP-1 drugs. Between 2024 and 2025, pharmaceutical spending at MassHealth climbed by 18%, with “fully half of that” due to GLP-1 drugs, Mahaniah said.
The secretary likened the GLP-1 landscape to previous restrictions on hepatitis C treatments.
“It was so expensive when it came out that we were making rules about what conditions we could cover,” Mahaniah said. “And then within five years, it was routinely covered because the price had come down so much. I’d be shocked if the same thing doesn’t happen to GLP-1s.”
Lawmakers this session have not offered major proposals to rein in health care spending that routinely eclipses the state’s cost containment target. Mahaniah said Healey’s Health Care Affordability Work Group is working “feverishly” to produce recommendations.
The group so far has largely focused on stabilizing the health care ecosystem, streamlining administrative procedures and growing the workforce, according to Mahaniah. He said the group is on track to deliver its first slate of recommendations in June.
“We’re particularly interested in recommendations that can be put into law. And also things that don’t need legislation because those are easier to do in a short period of time,” Mahaniah said. “An example is let’s say we decided to do something pretty radical around how we code or how we adjudicate coding claims — that would be something that could be done without legislation, because that’s essentially an agreement between the payers, the providers, the state.”
Additional recommendations will be released next winter, which Mahaniah said could be included in the governor’s next budget proposal.
“I expect that a lot of the meaty recommendations will be distributed between June and December,” the secretary said.
Beyond affordability issues, Mahaniah offered an assessment of looming health coverage losses as he testified before the Joint Committee on Racial Equity, Civil Rights and Inclusion. Chair Rep. Bud Williams lamented employment losses among Black women against the backdrop of the Trump administration — particularly those who are household breadwinners — and asked about the impact of the federal One Big Beautiful Bill Act.
Under the federal law, about 200,000 to 300,000 Massachusetts residents could lose their coverage, which could affect “a lot of households” with children, Mahaniah said.
“You’re automatically going to be hitting a lot of households that have kids,” said Mahaniah, who predicted disruptions to MassHealth and Supplemental Nutrition Assistance Program (SNAP) benefits will “disproportionately impact single moms.”
Mahaniah added, “I think you will see a crushing impact on households here in Massachusetts, especially those on the lower economic end.”
Premium increases driven by the expiration of federal subsidies could also push more people into poverty and increase medical debt, said Massachusetts Budget and Policy Center President Viviana Abreu-Hernández.
“As people are drowning in debt,” Abreu-Hernández said in written testimony, “it makes it that much harder to accumulate savings and, in turn, wealth.”