The Maine Legislature is considering a new bill that would require MaineCare to cover weight loss medications like Ozempic.
The proposal was discussed during a public hearing held by the Health and Human Services Committee on Tuesday.
Ozempic, along with similar drugs such as Wegovy and Zepbound, is designed to aid weight loss by controlling appetite and reducing cravings. However, the high cost of these medications—typically ranging from $1,000 to $1,500 for a 30-day supply—has led some private insurers to exclude them from coverage, sparking lawsuits, including two in Maine.
Despite the price, these drugs have become popular. A 2024 poll by KFF found that 1 in 8 adult Americans have used medications in the Ozempic class.
Originally approved by the FDA as a diabetes treatment, Ozempic and its counterparts have also shown effectiveness in weight control. However, about 40% of users take them for diabetes management, 22% for weight loss, and the rest for other medical reasons.
Rep. Anne Graham, D-North Yarmouth, a retired nurse practitioner and the bill’s primary sponsor, argued that MaineCare should cover these medications. She said patients need access to all available tools to improve their health.
“Everyone should have access to obesity treatment, including these weight loss medications,” Graham stated.
Thirteen other states, including Massachusetts, Connecticut, and Rhode Island, have already approved coverage for Ozempic and similar medications through their Medicaid programs. MaineCare is Maine’s version of Medicaid, a federal program managed by the states and funded with both federal and state money.
Dr. Allen Browne, a retired pediatric surgeon from Falmouth, spoke in support of the bill, saying it is “wrong” to tell patients that a drug is “safe and effective, but it’s not available due to the cost.” He added that some healthcare providers avoid even mentioning the drugs to patients because they know they are unaffordable.
However, Courtney Pladsen, MaineCare’s medical director, testified against the bill, warning that it would be too expensive. Pladsen explained that covering these drugs would cost MaineCare $42 million in 2026 and $53 million in 2027.
“Our conclusion is that the cost of adding this coverage would be prohibitive,” Pladsen said, noting that while children in MaineCare can be prescribed Ozempic or similar drugs, they are not available for adults in the program.
MaineCare is already facing an $118 million shortfall this fiscal year. Governor Janet Mills’ budget proposal aims to address this by implementing controversial cutbacks, including eliminating a cost-of-living increase for direct care workers and reducing stipends for childcare workers. The $11.6 billion biennial budget also seeks to raise revenue by increasing the cigarette tax from $1 to $3 per pack and hiking the sales tax on recreational cannabis by 40%, to 14%.
