Berrien County delays final action on GLP‑1 coverage; board to meet Blue Cross Blue Shield and purge employee mailing list

The Berrien County Board of Commissioners discussed whether to maintain or eliminate county health-plan coverage for GLP‑1 medications — drugs prescribed for type 2 diabetes that are also used off-label for weight loss — and directed staff to seek options from the county’s third‑party administrator, Blue Cross Blue Shield.

A commissioner reviewed a current resolution that would end coverage for GLP‑1 drugs at the end of the calendar year except when prescribed by a physician for type 2 diabetes or prediabetes. Because employees are currently making open-enrollment choices and because commissioners wanted more information on clinical, budgetary and procurement implications, the board agreed to form a small working group comprised of board chairs and vice chairs, staff (including the county administrator), and other designated members to meet directly with BCBS and request a cost‑benefit analysis and alternative coverage proposals.

Multiple commissioners and staff raised concerns about timing, employee impacts, and budget consequences if coverage were removed immediately. Board members cited: (1) rapidly changing market prices for GLP‑1 drugs as new competitors and pharmacy channels (Costco, Walmart) enter the market; (2) the need to reconcile union letters of understanding; and (3) the practical effect on employees who rely on the medications. Several commissioners supported delaying termination for up to six months while the county meets BCBS and explores alternatives; others said they would not support extending coverage if the additional cost would prevent adoption of a balanced budget.

The board also addressed a data‑handling concern: staff reported a mailing list had been created from protected employee information used to notify employees taking GLP‑1 medications. Commissioners directed that the list be purged from county computers "today," saying such mailings should originate from the carrier, not from county staff. The board asked staff to secure BCBS representatives for an early‑week meeting and to report back to the board, with any proposal from BCBS explaining why the carrier should continue to administer the county plan.

No formal vote to restore or eliminate coverage was recorded during the discussion. The board’s direction is procedural: obtain BCBS cost proposals and data, meet with the carrier, purge the mailing list and return with options; staff also noted the need to consider union agreements and the open‑enrollment timeline when drafting any budget adjustments.

Direct quotes in the meeting included commissioners’ factual observations; for example one commissioner said the drugs “are a fast moving pharmaceutical” and suggested that competitive market entry “promotes better pricing.” Another commissioner asked staff to “purge that mailing list today,” citing concerns about protected information.

Next steps provided by the board: staff will invite Blue Cross Blue Shield to present options early next week; a board working group will review cost‑benefit material; staff will confirm the budgetary impact if coverage is continued during an interim period; and the county will remove the mailing list used to contact employees taking GLP‑1 medications.