Weight loss drugs to be included in ND Affordable Care Act

FARGO, N.D. (KVRR) — Starting in 2025, North Dakotans can get weight loss drugs if they’re insured through the Affordable Care Act.

“A year from now feels like a long time to wait but it’s all part of the process. We’re excited about the opportunity to offer these benefits to North Dakota consumers. Especially those who have to purchase their own health insurance,” says Jon Godfread, the North Dakota Insurance Commissioner.

There will be more benefits that will limit the costs for insulin, hearing aids, oral care, opioids and PET scans.

Godfread says there’s nothing really earth-shattering within the new plans except for insurance now covering weight loss drugs.

“Those are relatively new. They’ve sought FDA approval. It’s Wegovy and Mounjarno are kind of the buzzwords that you’re hearing out there. A lot of really good progress has been made on those drugs. Obviously, you still got to work with your doctor, you got to have that discussion on what’s right for you. But, having that covered under the EHB plans and our ACA plans, really could make a meaningful impact.”

With weight loss drugs becoming more popular even among folks who may not need it, state officials say it’s a great first step to ensure those who do need it can get it under doctor’s approval.

“Oftentimes, they’re not getting it when they need it necessarily because of insurance issues. It’s a relatively new treatment plan, protocol. By proactively saying, ‘Nope, these types of things are going to be covered and we’re going to look at having that coverage available for North Dakotans.’ That ties in a lot of the back-end paperwork between the doctor, insurer and consumer.”

He says there will be more coverage for nutritional screening or conditions that could be managed through a weight-loss program.

“A lot of the things that we tie back to, whether that’s hypertension, cancers, other health issues we have. You can tie that back to weight management and being able to control your weight level. We felt it was very important to have these pieces included in the plans to give our consumers that option to, again, hopefully get those issues under control. If we can catch it on the front-end, it prevents a lot of further issues down the road.”

The last legislative session adopted a resolution that empowered the insurance commissioner to make changes to the state’s Essential Health Benefits.