{"id":660975,"date":"2026-03-17T01:48:13","date_gmt":"2026-03-17T01:48:13","guid":{"rendered":"https:\/\/www.europesays.com\/us\/660975\/"},"modified":"2026-03-17T01:48:13","modified_gmt":"2026-03-17T01:48:13","slug":"boston-wants-to-limit-glp-1-drug-coverage-amid-rising-costs","status":"publish","type":"post","link":"https:\/\/www.europesays.com\/us\/660975\/","title":{"rendered":"Boston wants to limit GLP-1 drug coverage amid rising costs"},"content":{"rendered":"

Ashley Groffenberger, the city\u2019s chief financial officer, sent a letter<\/a> to the City Council on Monday, saying health insurance rates for city employees are poised to spike by nearly 23 percent in the fiscal year that starts in July \u2014 the highest year-over-year increase in premium costs the city has seen \u201cin recent history.\u201d Boston included $483 million for all health-related benefits for employees and retirees in its budget for this fiscal year, according to the city<\/a>.<\/p>\n

The hikes will be borne by workers, too, she warned. She said for workers in one of the city\u2019s Blue Cross Blue Shield family insurance plans, the monthly premium costs could increase from $655 to $803, or $1,773 for the year. <\/p>\n

Groffenberger wrote that nearly 15 percent of the city\u2019s overall projected increase <\/b>is driven by the rise in city employees taking GLP-1 medications. Coverage for those drugs cost roughly $32 million this fiscal year but is expected to jump by 50 percent to more than $47 million next year, she wrote. <\/p>\n

The city\u2019s health insurance system covers about 55,000 members of the city\u2019s workforce, their families and retirees. Groffenberger said about 8 percent of city workers on non-Medicare health insurance plans take GLP-1 drugs for weight loss purposes, though it wasn\u2019t immediately clear Monday exactly how many employees that covers. <\/p>\n

In an effort to avoid eliminating coverage of GLP-1 drugs entirely, Groffenberger told the council that the city sought permission from its employees\u2019 unions to change their health care plans to implement \u201cutilization management\u201d \u2014 essentially requiring doctors to get approval from employees\u2019 insurance providers before prescribing certain medications. <\/p>\n

That change would save the city between $8 million and $9 million a year, Groffenberger said. The city\u2019s Public Employee Committee, which represents unionized city employees and retirees in health insurance negotiations with the city, voted against approving that change earlier this month, she wrote.<\/p>\n

Larry Calderone, president of the Boston Police Patrolmen\u2019s Association, the city\u2019s largest police union, told the Globe that it is open to negotiations with the city over how to keep health insurance costs down.<\/p>\n

\u201cEverybody\u2019s experiencing tough times out there financially, and any increase is going to take away from some other budget portion of a family\u2019s income,\u201d Calderone said. \u201cMy best scenario is to keep everybody covered with the medications they need, at the lowest cost.\u201d<\/p>\n

The Boston Teachers Union did not immediately respond to the Globe\u2019s inquiry for this story Monday. The Boston Firefighters IAFF Local 718 declined to comment.<\/p>\n

Elissa Cadillic \u2014 cochair of the Public Employee Committee and president of AFSCME Local 1526, the Boston Public Library employees union \u2014 said Monday they\u2019re concerned that the city\u2019s move to require prior authorization could impact all non-specialty medications, not just GLP-1 drugs. <\/p>\n

She also questioned how much money \u201cutilization management\u201d would actually save the city each year. <\/p>\n

But Groffenberger is now <\/b>asking for the council\u2019s support in asking for the Public Employee Committee to hold another vote and agree to the change before the end of the week. <\/p>\n

Otherwise, she said, the city would have to consider other options, including joining Massachusetts\u2019 Group Insurance Commission, which eliminated coverage of GLP-1 drugs for state employees<\/a> last month. The Group Insurance Commission board, which approved the change, cited budget challenges and surging costs. About 22,000 GIC members currently take GLP-1 drugs<\/a> for weight loss, at a total cost of $46 million, state officials said.<\/p>\n

Groffenberger told council members in her letter that the city\u2019s revenues are projected to increase by just 1.5 to 2.5 percent next fiscal year, saying the city has \u201cfewer resources available to absorb these increased costs.\u201d<\/p>\n

\u201cThese significant financial impacts require a departure from standard practice,\u201d Groffenberger wrote. <\/p>\n

\u201cGiven these unprecedented circumstances, and unaffordable increases in cost for our employees and the City, our administration has requested that the PEC leadership reconvene and take new votes on the options presented no later than Friday,\u201d she continued.<\/p>\n

Cuts to GLP-1 coverage have proliferated across the country. Several states have cut coverage for the pricey drugs under their Medicaid program, including New Hampshire, where officials planned to cut coverage for weight loss in January<\/a>. <\/p>\n

North Carolina ended coverage<\/a> for obesity last fall, citing \u201cshortfalls in state funding,\u201d roughly a year after it dropped coverage under<\/a> the state employees\u2019 health plan of the same class of drugs because of rising costs.<\/p>\n

New York City officials said in 2024 they, too, were dropping coverage for weight-loss drugs after reportedly saying they had been paying for them \u201cin error<\/a>.\u201d<\/p>\n

More than 40,000 customers of Massachusetts\u2019 two biggest insurers, Blue Cross and Point32Health<\/a>, have lost coverage of GLP-1s for obesity this year, according to the data the companies provided to the Globe<\/a>. An unspecified number of customers of smaller insurers have also lost the benefit.<\/p>\n

Niki Griswold can be reached at niki.griswold@globe.com<\/a>. Follow her @nikigriswold<\/a>.<\/p>\n