When Life-Saving Medication Becomes a Budget Line Item, Who Pays the Price?
The cost of keeping government workers healthy in the Virgin Islands may soon come at the expense of cutting off their treatment. At a recent Government Employees’ Service Commission (GESC) meeting, Health Insurance Board officials revealed that the government health plan’s cost is projected to exceed $190 million next year—a record high. In response, the board is proposing a 17.5% increase in employee premiums and is considering eliminating coverage for popular weight-loss drugs such as Ozempic, Wegovy, and Mounjaro.
The challenge lies in their cost. With monthly prices ranging from $1,000 to $1,300 per patient, the popularity of these medications is straining the self-funded plan, which is financed by local government contributions and employee premiums. Unlike Medicare or private insurers, the USVI’s plan lacks the negotiating power to secure lower prices from drug manufacturers.
Richardson indicated that removing coverage for these medications is a possibility, though some board members have expressed concerns about the broader public health implications. They questioned whether cutting these drugs might lead to higher long-term costs due to increased hospitalizations, complications, and disabilities, potentially offsetting any short-term savings. The board also noted that eliminating coverage could reduce the proposed premium increase by two percentage points this year.
In the meantime, the board is exploring the expansion of “wellness programming” to promote healthier lifestyles. However, no concrete plans have been presented, and employees would still face higher premiums, whether the increase is 17.5% or 22%.
This raises critical questions: Is it fiscally responsible to cut coverage for these medications? Or is it short-sighted to abandon treatments that could prevent long-term health issues?
Government employees and retirees affected by the GESC plan are encouraged to voice their concerns. The Health Insurance Board is expected to finalize its decisions before the next fiscal year begins. Feedback can be submitted to the GESC through the Division of Personnel or by contacting local Senators.
One decision could reshape access to healthcare across the Virgin Islands.
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