[{"_1":2,"_112":-5,"_113":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88,100],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6607670,"mediaKeyId","2948631-14cfd2c60fc3d7377de6403adb681104","parentId",2948631,"title","Comptroller and health directors flag rising pharmacy costs and GLP‑1 drugs as a major fiscal pressure","audioSeconds",695,"startMs",1185000,"endMs",1880000,"viewUrl","/Search/View?dp=1&key=2948631-14cfd2c60fc3d7377de6403adb681104&start=1185&end=1880","thumbnailUrl","https://assets.pipeline.soar.com/2948631-14cfd2c60fc3d7377de6403adb681104/thumbnail_1185000.jpg","articleUrl","/articles/6607670/Connecticut/Comptroller-and-health-directors-flag-rising-pharmacy-costs-and-GLP1-drugs-as-a-major-fiscal-pressure","mediaUrl","https://secure.pipeline.soar.com/6607670-6cb7581e85e509a10a746b992c5bed76/orig.mp4?Expires=1775388637&Signature=coyPtu93fxdDUT1A6lHgc2ECpSsh-TObWOgozTCqAjZ94F80Q3uHC1HQ7TVLqebNFh2JHKFitUCXhrR~oLK-j~0d66IQWuF8cuHhxeSlNom-LoA4XKO2FYcqkYkeB4ZKejYsSW751m1dVFjRC6cm0FFVjD8QfTbRP3paCvBkb74s1kBLjrZWmpTUWXGRB8pFMo32ktlqUeYAq27vFJEFunluJM5ZFvVSelRTwClzUx8qoaq30IZbuM9hQQ2NwsvD7ZkjjRYuJWErcqnivKP9F93bwXuF5SAziENcVUHpHDZaBBtgbs0ULxwtOy0VN7J4GCWDeOZ8fmf6fIuv5We4gA__&Key-Pair-Id=KUT5TJCACFTXG","author","Connecticut House Of Representative Appropriations Committee","date","2025-04-10T18:13:07.127Z","article","State fiscal managers and the comptroller’s office told the Appropriations Committee that pharmacy costs are a cross‑cutting driver of multiple agency shortfalls, and that recent changes in drug use and pricing are creating budget uncertainty.

Comptroller’s overview: Tara Downs, the deputy comptroller, described several lines of deficiency work the office handles and introduced the agency’s witnesses. The comptroller’s health and benefits staff described 2 primary pharmacy-related pressures: rapid uptake of GLP‑1 medications (used for diabetes and recently for weight management) and an increase in specialty and high‑cost biologic drugs.

“Last fiscal year we spent about $40,000,000 on GLP‑1s. This fiscal year we expect to spend around $65,000,000,” a witness said, describing a roughly 50 percent increase in that single prescription class. Comptroller staff explained that while some pharmacy contracts include dollar‑for‑dollar guarantees above certain spending thresholds (in the state’s case, with CVS), the underlying trend of higher utilization and the decline in rebate rates increases the program’s net cost.

PBM and contracting changes: OMB and agency witnesses said they are reconfiguring PBM contracts to align incentives with the state. Historically, formularies were designed to maximize list‑price rebates; new contracting aims to prioritize net cost and clinical value. One executive said the state is “actively … making adjustments” to formularies and seeking PBM recommendations to prefer higher‑value, lower‑cost drugs when clinically appropriate.

Why it matters: Pharmacy and retiree health costs affect both general‑fund liabilities (retiree health and state employee plans) and Medicaid. For large programs, small percentage shifts in rebates or drug mix translate into multi‑million‑dollar changes in required appropriations. Comptroller staff said they are going to tighter procurement clauses, adjust prior authorization and utilization-management rules, and seek market bids for Medicare Advantage retiree plans to manage premiums.

Ending: Committee members pressed for clearer near‑term forecasts; the comptroller’s office and agencies said they will provide updated monthly letters and suggested further legislative discussion on long‑term policy levers.","mediaType","Video","parentTitle","Appropriations Committee Public Hearing re Deficiency Bill","oneSentenceSummary","The state’s comptroller and health benefits staff told lawmakers that sharp growth in GLP‑1 prescriptions, specialty biologics and weakening rebate rates are a key driver of deficit pressures across state retiree plans, active‑employee health plans and Medicaid.","taxTitle","Appropriations, House of Representatives, Committees, Legislative, Connecticut","taxId",15021,"location","Connecticut","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6607673,"Department of Social Services reports roughly $204 million Medicaid shortfall at appropriations hearing",2769,7216000,9985000,"/Search/View?dp=1&key=2948631-14cfd2c60fc3d7377de6403adb681104&start=7216&end=9985","https://assets.pipeline.soar.com/2948631-14cfd2c60fc3d7377de6403adb681104/thumbnail_7216000.jpg","/articles/6607673/Connecticut/Department-of-Social-Services-reports-roughly-204-million-Medicaid-shortfall-at-appropriations-hearing","https://secure.pipeline.soar.com/6607673-d893a011116d66ee700c6feddcee22fa/orig.mp4?Expires=1775388637&Signature=d58B6zGeu7PAoRv9XFw5dU05iroeoCbr4rjWwz-4Q6tkWn23u5YLXxLGoSJrm5wm~uiThCfoehxhg04h9JWe1QPbvxKzJPVq80BGElPCoNk5tzLhrvU-8fte4Sx-MPRBJKc7rHjGW2zRHkhiqUzUeaAsfc6BNcp~gxgB5yY7TXBueZ-OLGBT7QfzogCZ6XwUuvqO~19Lsh26nwp2uMPUNdTK62iJmO5u~fB3dRWedNWyl~B5rrDd3zvVaKKOU~HjKP~EsvPq~SKa5veqSTVCOuIXLWIQxV5b8Ve9QVc6gwd~gHk~mWvLMXlhoRRBAmgiEjMWNr8nMkYpuHz3LHTlGg__&Key-Pair-Id=KUT5TJCACFTXG","The Department of Social Services told the Appropriations Committee that Medicaid is the largest single driver of the state’s deficiency estimates for fiscal 2025, citing higher per‑member medical costs, faster growth in home‑and‑community‑based services and waivers, and rising pharmacy spending.

DSS officials described the shortfall as a multi‑part problem. “The current Medicaid deficiency is …” said a department official listing the program shortfall when summarizing testimony to the committee. Agency staff said the key drivers include an increase in per‑member per‑month (PMPM) spending on Husky C (the state’s higher‑cost Medicaid population), rapid growth in home‑and‑community‑based services and waivers, and a national trend of higher prescription drug costs combined with a drop in drug rebates that historically offset pharmacy spending.

Why it matters: Medicaid is a major portion of the state budget. Even modest percentage increases in utilization or drug spending can translate to large dollar impacts on the general fund because of the program’s size and the state share of expenditures.

Details from testimony: Department witnesses told the committee the Husky C PMPM rose notably — the department cited an increase from roughly $3,105 to $3,339 for a recent period — and home‑care waivers such as the Connecticut Home Care waiver and Community First Choice now serve thousands more recipients at several thousand dollars per person per year. Officials also noted that each 1 percentage‑point drop in drug rebates equates to roughly $20 million in gross pharmacy spending (about $8 million state share).

Agency response and next steps: DSS said it presented an updated Medicaid budget in the mid‑session update earlier this year and that the governor’s recommended budget did not incorporate all of the department’s mid‑session adjustments. DSS requested continuing engagement with legislators to align projections, asked for the final enacted deficiency action before the fiscal year ends, and flagged that federal changes could add uncertainty.

Ending: Committee members asked for follow‑up materials to reconcile monthly projections and requested more granular data on enrollment mix, the movement of recipients between institutional and community‑based care, and pharmacy‑trend modeling.","DSS officials told the Appropriations Committee the Medicaid program is the largest driver of the state's deficiency projections, citing higher per‑member costs, growing home‑and‑community‑based services, and rising pharmacy spending.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":93,"_47":94,"_49":95,"_51":96,"_53":97,"_55":56,"_57":58,"_59":98,"_61":62,"_63":64,"_65":99,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6607675,"Appropriations hearing opens on deficiency bill as agencies warn of rising costs, staffing shortfalls",11953,389000,12342000,"/Search/View?dp=1&key=2948631-14cfd2c60fc3d7377de6403adb681104&start=389&end=12342","https://assets.pipeline.soar.com/2948631-14cfd2c60fc3d7377de6403adb681104/thumbnail_389000.jpg","/articles/6607675/Connecticut/Appropriations-hearing-opens-on-deficiency-bill-as-agencies-warn-of-rising-costs-staffing-shortfalls","https://secure.pipeline.soar.com/6607675-847ad2898a68e222f0972766721a7b9e/orig.mp4?Expires=1775388637&Signature=ERKhD~TwRLO~Cw0OWhdzy5oKLHXn-L57qYJmkF8AXSn66nTUPQtU3RbncSiXfIo-ADZEGA401M3RqMKeApto5slC4VTZPbzdoxFgUt3QueM-2McYZo6zk0aNj5JNMf5fPtTtWji9U~telKBsQ6tzZgArPRHu2xOs4UBbmXFiCmKbztp2onEAzKIy1Au56aIaSg8bXulfXNmHhuhyheOfFZCw7gCSyWf7l4j-iGYLtQjj1zQPa1Cd8PU83L6Cjhgk2t9xuKfnmxdkMXXEA0n2Us27qejnnP-HhxYWhgrooF0GY~gbsgGJhzxCPCRksOIiFjmCRj24-9MJIHFeIcMMcw__&Key-Pair-Id=KUT5TJCACFTXG","The Appropriations Committee opened a public hearing on the deficiency appropriations bill, House Bill 6863, saying the measure will be updated before final enactment to cover shortfalls across state agencies.

The bill, which the committee is treating as a rolling document, will be revised as agencies submit updated deficit letters and the governor’s office and Office of Policy and Management (OPM) update projections. “We’re here to talk about our deficiency appropriations bill, which happens to be, House Bill 6 8 6 3,” said a state official opening testimony. Committee members heard agency-by-agency briefings and questions about major cost drivers and mitigation steps.

Why it matters: The deficiency bill provides supplemental authority for spending required before the fiscal year ends June 30. Lawmakers use the bill and administrative transfers to keep programs running and to attempt to remain under the state spending cap.

Most agencies described multi‑factor shortfalls rather than a single cause. Common themes included rising prescription drug costs and pharmacy trends, unanticipated utilization of health-care services, higher utility and commodity prices, and staffing shortages that increase overtime and workers’ compensation costs. The comptroller and several agencies described pharmacy-track problems that affect both retiree and active-employee plans and the Medicaid program.

Testimony and administrative actions: Witnesses told the committee they are updating projections monthly and that Finance Advisory Committee (FAC) transfers and administrative holdbacks have reduced but not eliminated many shortfalls. Agencies repeatedly said more monthly letters will follow and that final numbers will be set before the session ends. The Department of Administrative Services and other agencies said they are trying to contain costs through hiring pauses, reorganization, cross-training, and limited use of third-party vendors.

What’s next: Agency leaders will deliver updated deficiency letters and the committee will consider whether the deficiency bill’s appropriation levels and FAC transfers are sufficient. Several speakers urged caution in assuming future federal funding and asked legislators to consider longer-term budget adjustments.

Ending note: Committee members pressed agencies on the details of their forecasts and the extent to which shortfalls represent structural changes (for example, sustained drug trends or long-term shifts in Medicaid enrollment) versus one-time items. The committee did not take votes at the hearing; it received testimony and will meet again as updated projections arrive.","Lawmakers heard a wide-ranging briefing on House Bill 6863, the annual deficiency appropriations bill, with agency leaders and the comptroller describing shortfalls driven by health-care spending, drug costs, utility and commodity inflation, and staffing-related overtime.",{"_33":101,"_35":36,"_37":38,"_39":102,"_41":103,"_43":104,"_45":105,"_47":106,"_49":107,"_51":108,"_53":109,"_55":56,"_57":58,"_59":110,"_61":62,"_63":64,"_65":111,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6607667,"Corrections warns of multimillion‑dollar shortfall as staff vacancies, overtime and inmate medical costs rise",1219,14068000,15287000,"/Search/View?dp=1&key=2948631-14cfd2c60fc3d7377de6403adb681104&start=14068&end=15287","https://assets.pipeline.soar.com/2948631-14cfd2c60fc3d7377de6403adb681104/thumbnail_14068000.jpg","/articles/6607667/Connecticut/Corrections-warns-of-multimilliondollar-shortfall-as-staff-vacancies-overtime-and-inmate-medical-costs-rise","https://secure.pipeline.soar.com/6607667-8cff88247c2d6ca5c022137e9c7c2363/orig.mp4?Expires=1775388637&Signature=g-19Qu7GDtRo1LdpkWylgvx7sqBypM2lRbUBqGzmNGWmw~Mgv1W5-UlAwd9NsqQsG~eoqkssBWlk3C46t4HtKMne8Mu3lwee1rqB-7rxJUbM~HEAxhvtv~6fBHk5oJUdLWixc72KkKGzC61I~3~sHYwJHTGzid55SOlsRapRXXm3DGnOpRrzmpWGV-UDfHCd1e-5QrBRrQeANihGy7GqMimFySf1Zl3kH8WO3RJTSQerI3NubGfOq555~~K0vGqwsDplPJSs3P97W10TSoNSuFPpFahDfkawuk3dh2qhTsJot15W~6fU7FULyFEKH0aaC9y5gAS96mMj0jUcHhf-gA__&Key-Pair-Id=KUT5TJCACFTXG","The Connecticut Department of Correction told the Appropriations Committee a combination of staff vacancies, rising overtime, increased worker injuries and higher inmate medical costs has produced multi‑million‑dollar shortfalls that required transfers and administrative actions.

“On April 3 the Finance Advisory Committee approved transfers … to cover a projected deficit,” DOC officials said, describing a mix of personal‑services and operating shortfalls. The agency reported it had more than 480 correction‑officer vacancies and that a recent training class of 100 officers began the academy; additional classes are planned. In the meantime DOC said it relies on overtime to maintain minimum staffing. The commissioner also reported about 65 employees remained out on workers’ compensation for 30 days or more; in calendar 2024 more than 800 employees had workers’‑comp claims of varying duration.

Why it matters: Staffing shortfalls and high overtime increase per‑shift labor costs and are linked to higher workers’ compensation and recruitment pressures. Rising inmate medical utilization and prescription costs add another material expense to corrections budgets.

Details: DOC officials said FAC approved transfers of tens of millions of dollars to cover deficits in other expenses and inmate medical services; the agency cited utility, food and supplies inflation for non‑personnel shortfalls, and higher‑than‑expected inmate population and costly outpatient pharmaceuticals and specialty medicines for medical account increases.

Agency actions and next steps: DOC said it plans additional recruit classes, ongoing hiring, and to work with OPM and the committee on staffing and budgeting for the next fiscal year. Committee members asked DOC for a breakdown of recruitment, vacancy, overtime and workers’‑comp measures to better understand long‑term staffing needs and the agency agreed to provide data.

Ending: The committee did not vote; members asked for follow‑up data on overtime hours, vacancy trends, and workers’ compensation claims and their drivers.","The Department of Correction told the Appropriations Committee that high overtime driven by more than 400 corrections‑officer vacancies, rising workers’ compensation cases and increased inmate medical and pharmaceutical costs have produced multi‑million dollar deficiencies that required FAC transfers.","actionData","errors"]

Article not found

Comptroller and health directors flag rising pharmacy costs and GLP‑1 drugs as a major fiscal pressure

Department of Social Services reports roughly $204 million Medicaid shortfall at appropriations hearing

Appropriations hearing opens on deficiency bill as agencies warn of rising costs, staffing shortfalls

Corrections warns of multimillion‑dollar shortfall as staff vacancies, overtime and inmate medical costs rise