Gov. Jim Justice told press during his Tuesday, Nov. 26, 2024 briefing that he’s been taking the weight-loss drug Ozempic, and supports expansion of access. (Screenshot from Gov. Jim Justice’s briefing)
West Virginia Gov. and Senator-elect Jim Justice said Tuesday he supports a plan by President Joe Biden’s administration to expand access to costly weight-loss drugs like Ozempic and Wegovy, but acknowledged that their prices might be a concern.
The Biden administration announced Tuesday a proposal to reinterpret a federal law to no longer exclude the drugs being used to treat obesity from Medicare part D coverage and to require Medicaid to cover the drugs when used to treat obesity.
The governor said during his administrative briefing he doesn’t know how to expand access to the drugs “from the standpoint of the cost” and said sustainability must be part of the puzzle.
“For all I know about these drugs, they are beneficial in many different ways,” Justice said. “And the net net of the whole thing at the end of the rainbow — it’ll save us money. It’ll save us money. But we’ve got so much that we’ve got to do to overhaul this colossal mess in D.C. It’s unbelievable. That’s just all there is to it.”
“I would be a proponent of trying to do everything we can to be able to expand these drugs that you’re talking about to everybody,” Justice said. “Because at the end of the day it will save us tremendous amounts of money.”
Justice added that he is currently taking the drug Ozempic, a GLP-1 used to treat diabetes and weight loss, and that he’s lost “30, 40 pounds, maybe even 50 pounds.”
Justice said the “battleground” about expanding access to the drugs will be the cost and there will be arguments about the health benefits.
A monthly supply of Ozempic and similar drugs can range from $936 to $1,349, according to KFF Health News.
Premiums for members of the West Virginia Public Employees Insurance Agency are proposed to rise by more than 10% during the next fiscal year, in part because of the costs of drugs like Ozempic. PEIA director Brian Cunningham has said that rising prescription drug costs — particularly drugs for obesity and diabetes — are a big driver of the proposed rate increases.
GLP-1s accounted for $53 million, or 20% of the net drug spend for PEIA last year, Cunningham said. Earlier this year, the agency suspended a pilot program that covered the cost of the drugs to treat obesity.
President-elect Donald Trump’s administration would need to approve CMS’s proposal, which is expected to cost $25 billion for Medicare combined with $11 billion in federal spending and $3.8 billion in state spending for Medicaid coverage throughout the next decade.
Medicaid is a state and federal program that covers more than 500,000 West Virginia residents, according to November numbers from the state Department of Human Services. The department did not immediately respond to an email asking for comment on Biden’s proposal.
West Virginia has the highest obesity rate in the country, at 41% in 2022.
Trump had not commented on the proposal as of Tuesday afternoon. His pick for HHS secretary, Robert F. Kennedy Jr., has criticized the drugs.
“If we spent about one-fifth of that giving good food, three meals a day, to every man, woman and child in our country, we could solve the obesity and diabetes epidemic overnight,” Kennedy said on an appearance on Fox News.
The Centers for Medicare and Medicaid Services said it expects about 3.4 million people in the Medicare program would become eligible for anti-obesity medication coverage under the proposed rule that would take effect in 2026 if Trump decides to finalize it.
The proposal is expected to cost $25 billion for Medicare combined with $11 billion in federal spending and $3.8 billion in state spending for Medicaid coverage throughout the next decade.
“Our loved ones with Medicare deserve care that puts their interests first. HHS is proposing to improve transparency, accountability, and consumer protections in Medicare Advantage and Part D plans so that everyone receives high-quality care,” Xavier Becerra, secretary for the federal Health and Human Services, said in a statement. “To achieve that, we want to remove barriers that delay care or deny people services and medications they need to be healthy. In addition, we continue to promote competition for pharmacies and other health care businesses.”
Jennifer Shutt of State’s Newsroom’s DC Bureau contributed to this story.
GET THE MORNING HEADLINES.