House deadlocks on pilot to require state health plan cover GLP-1 weight-loss drugs; vote ties 50-50

Representative Rosenzweig sponsored House Bill 783, which would require the state employee health plan to cover medically necessary glucagon‑like peptide‑1 (GLP‑1) receptor agonists for people with class‑3 obesity (body mass index of 40 or higher) and for polycystic ovary syndrome when medically necessary.

Rosenzweig said the bill is a narrowly targeted, two‑year pilot limited to state employees and noted that 13 other states have adopted similar mandates for certain conditions. “This bill addresses the time period between being dangerous prediabetic and becoming fully diabetic by requiring that insurers cover the cost of the drugs when prescribed by a doctor for patients with significant type 3 obesity risks or polycystic ovarian syndrome,” Rosenzweig said.

Proponents argued the drugs can be effective at reducing long‑term health costs by preventing diabetes and other complications; supporters cited studies that estimate annual medical‑cost savings between $1,500 and $8,000 per treated person depending on comorbidities and the study cited. The bill includes an appropriation line in the draft (sponsor and committee members cited a $1.5 million per year figure for initial implementation in the state plan) and requires a two‑year review of utilization and cost effectiveness.

Opponents pressed on short‑term costs and side effects. Representative Perry, who said he had personal experience taking Ozempic, described effectiveness but noted gastrointestinal side effects and the current retail cost of the drugs. Majority Leader Fitzpatrick and others argued that mandated coverage would raise overall insurance costs and create a new benefit for state employees that other Montanans would not receive.

Lawmakers also questioned the fiscal-note assumptions and utilization projections. Sponsors said the original fiscal note had been drafted under a broader version of the bill and that committee amendments narrowed coverage to reduce long‑term fiscal exposures; the sponsor and others said the revised appropriation request for the two‑year pilot was about $1.5 million for the first year and about $1.2 million for the second year for the internal state plan.

At final call, the House recorded a tie: 50 representatives voted aye and 50 voted no. Because the measure did not gain a majority, House Bill 783 failed second reading.

The transcript records extended debate spanning clinical questions, concerns about long‑term side effects and liability, and several requests for reporting and utilization limits. The bill would have applied only to the state employee plan as written in the version considered on the floor.