Can California afford to cover Ozempic for state employees?

In a rare show of bipartisan support, the state Senate in May voted overwhelmingly to pass a bill that would potentially help hundreds of thousands of California state employees fight obesity by requiring their health insurance companies to cover anti-obesity drugs, or GLP-1 drugs, such as Ozempic.

So why is CalPERS, the health plan for 1.3 million state employees and retirees, recommending its board oppose the bill?

In one word: money.

In a new assessmentThe California Public Employees’ Retirement System says the bill would increase premiums by $437.2 million, or about $28 per member, per month. It will cost the state general fund $187.2 million in the first year alone. In the coming years, costs are likely to increase by “tens of millions of dollars per year.”

• CalPERS staffin its recommendation: “Broad coverage would strain health care resources because of the sheer scale of the eligible population. … Studies of the total cost of care in the commercial market have consistently shown that GLP-1 coverage increases total costs because the added costs far outweigh any savings from reduced health care use.”

The price could ultimately prove hard for Gov. Gavin Newsom to swallow if the bill clears the Assembly and reaches his desk. Just last year, Newsom convinced the Legislature to end of Medi-Cal coverage for weight loss drugs because of their cost.

Sen. Laura Richardson’s new proposal would create a five-year pilot requiring health insurers to cover treatment for the management of chronic weight diseasesincluding at least one GLP-1 drug. GLP-1 can also help manage blood sugar levels in people with diabetes.

Being overweight increases health risks, including developing heart disease, high blood pressure, and certain types of cancer. About 11 million adults in Californiaor 27%, are obese, according to the American Diabetes Association, a rate that is expected to rise to 41% in 2030.

In an April hearingRichardson cited his own experience of losing 43 pounds with the anti-obesity drug Zepbound. Because her doctor prescribed Zepbound for weight management, not diabetes, Richardson’s health insurance, CalPERS, does not cover it.

• RichardsonDemocrat from Inglewood: “Chronic weight management can be linked to reduced earnings from work participation, increased early mortality, absenteeism, disability and health care costs of more than $1 billion that impact our gross domestic product in California. … Why not offer something that can ultimately save you money?”

The CalPERS board plans to formally vote on its position next week. The Health Committee of the National Assembly is expected to consider the bill on June 16.

A recent report from an Oakland-based nonprofit found that a majority of California’s youth struggle with mental health issues. But with limited access to services, youth and teen advocacy groups are working to address the state’s problems poor mental health outcomesAnissa Durham writes for CalMatters.

Earlier this year, Children Now found that in an average month, 94 percent of Californians ages 14 to 25 report mental health problems, such as stress and anxiety. But health insurance denials, complex mental health services that are difficult to navigate, and a lack of access to youth-oriented places make it difficult to find help.

Children Now aims to make counseling and therapy more transparent by backing a bill that would require health insurers to report number of treatment refusals.

Sixteen-year-old Bryce Collins also works to help his peers in the Los Angeles Unified School District — especially black and Latino kids. Through his work with an organization working to end the school-to-prison pipeline, the high school student is advocating for more spaces in schools that protect students’ mental health.

• Collins: “Being a young black man lets me know how I have to approach some of these areas…I can’t do what everyone else does. I don’t have the privilege. I have to hold myself to a higher standard because society doesn’t usually look at us that way.”

Read more.

A federal judge handed down a loss to the Trump administration on Monday, ruling that its requirement for US employers to pay a $100,000 sponsorship fee for new H-1B visas is illegal.

c his decision U.S. District Court Judge Leo Sorokin of Massachusetts said the tax was imposed “without the necessary congressional delegation.” Arguments made by administration lawyers that President Donald Trump has the authority to impose a tax based on his “immigration and trade powers” are also “nowhere to be found in the authorities they cite,” Sorokin wrote.

Since September, the administration imposed the high fee arguing that the visa program companies use to hire skilled foreign workers “has been deliberately exploited to replace, rather than supplement, American workers.”

Sorokin’s ruling sided with 20 states, including California, in a multistate lawsuit challenging the policy in December.

• Rob BontaCalifornia’s attorney general, in a statement: “This tax was an attack on America’s ability to attract and retain the high-skilled talent that strengthens our economy and helps us meet critical workforce needs. California remains open for business, open for talent.”