BOSTON — State health plan overseers under pressure to tame spiraling health care costs delayed a vote on controversial benefit changes — particularly eliminating coverage for GLP-1 drugs for weight loss — in response to pushback from lawmakers and state workers.
As it seeks to rescue the commission this year with an emergency appropriation, the Healey-Driscoll administration also tasked the Group Insurance Commission with slashing $120 million in fiscal year 2027, which begins on July 1.
But GIC commissioners are continuing to push back on staff recommendations to shift costs to state workers, including nixing coverage for GLP-1 drugs for weight loss and raising copays for emergency room and urgent care visits. The commission oversees plans for more than 280,000 subscribers and 460,000 members — public employees and retirees as well as their dependents and survivors.
The GIC board on Thursday punted a decision on most changes until the next GIC meeting, requesting data from staff on how plan revisions could impact members. Commissioners also said they need additional time to pore through the flood of public opposition they’ve received in recent days.
The next GIC meeting is Feb. 26, though staff indicated a meeting could be scheduled sooner depending on when staff produce their analysis.
Early in the meeting Thursday, Executive Office of Administration and Finance designee Dana Sullivan broached the idea of tabling the scheduled vote on plan design changes.
“I’m requesting an impact analysis from the GIC on those proposed changes and their connection with premiums,” Sullivan said. “I know time is of the essence, since we have to set rates in time for open enrollment. I hope this analysis can be done quickly and that we can reconvene in the near future to vote with that information in hand.”
Sullivan also cautioned that the GIC’s spending is “unsustainably growing relative to the rest of revenue across the commonwealth.” Gov. Maura Healey recently asked lawmakers to deliver an additional $300 million for the GIC in fiscal year 2026, saying the agency will need that funding by April 30 to continue paying claims.
GIC Executive Director Matt Veno said staff will deliver an analysis as soon as possible, though he could not pinpoint an exact timeline. He warned that Thursday’s delay “seriously puts at risk our ability to just be ready for annual enrollment that starts on April 1.”
The GIC board approved two design changes Thursday: implementing a uniform methodology for health carrier reimbursement to out-of-network providers, as well as a copay assistance card program.
Board Vice Chair Bobbi Kaplan reflected on the demographic breakdown of the agency’s 460,000 members. She said “many” are Black and brown individuals, and said weight-loss medications are “critical to their health.”
“Many of our members hold second jobs so they can afford rent and food increases,” Kaplan said. “And it is unfair to try to save $120 million and to shift those costs to employees.”
Commissioner Darren Ambler urged the board to consider taxpayer fairness while wrestling with the changes.
“Most taxpayers in this state, the vast, vast majority, do not have a plan that is nearly as rich as the plan that is offered by the state through the GIC,” Ambler said.
Sixty state representatives wrote a letter to Healey on Wednesday opposing the plan design changes, saying they are “unlikely to solve any structural deficits” and “will permanently shift costs onto the state workforce.”
“GIC members will be left with a permanent, higher-cost plan design, when instead solutions to a short-term structural deficit or an attempt to [rein in] health care industry costs should be the priority,” the letter reads. “Future GIC costs could grow exponentially if families put off preventative care, leading to more costly surgeries and treatments in the future. The proposed plan design changes do not consider the expensive long-term impacts of reduced preventative care, which has been proven to lower health care cost increases overall.”
The House members also contrasted the GIC plan with the governor’s claims that her budget “is about making life easier and more affordable for Massachusetts residents and businesses,” asserting that higher copays and deductibles are “contrary to what you are trying to do for all of Massachusetts.”
About 20 senators sent a similar letter to Healey on Wednesday, warning that the potential changes “could bring real harm to the state workforce.”
“Copays and deductibles could become so unaffordable that families may be forced to choose other essential items like food and shelter over medicine and wellness care,” senators wrote.