Gov. Mike DeWine
Vern Riffe Center, 30th Floor
77 South High Street
Columbus, OH 43215-6117
Attn: Giles Allen, Director of Legislative Affairs

Gov. DeWine,

We, the undersigned organizations representing tens of thousands of patients, families, clinicians, and advocates across Ohio, urge your administration to use its authority to immediately remove the prohibition against Medicaid coverage for obesity medications (OMs), as outlined in §5160-9-03 of the Ohio Administrative Code. This outdated and prohibitory language stops Medicaid from using the regular coverage consideration process for OMs.

Our request comes at a time when Ohio has the opportunity to take advantage of significant downward price pressure on GLP-1s. Coupled with the recent publicly stated willingness of GLP-1 manufacturers to directly negotiate pricing with states, Ohio can take action to begin helping the seven out of ten Ohioans currently experiencing obesity or overweight.

In discussions we have held over the past year, your administration and the Department of Medicaid have made it clear that you agree with us: obesity poses a significant public health risk in Ohio.

While Ohio Medicaid provides coverage for metabolic and bariatric surgery, beneficiaries affected by obesity still lack access to the full continuum of care, particularly FDA-approved medications indicated for the treatment of obesity. Because the administrative code language prevents coverage of OMs, the Department of Medicaid can’t move forward to review this important drug class and enter into subsequent discussions to negotiate for rebates.

These Medicaid regulations create two different standards of health care where those affected by obesity are denied access to basic medications needed and clinically proven to improve their chronic condition.

Gov. DeWine, your administration has the power to take the critical first steps to ensure the Ohio Department of Medicaid has the option to cover GLP-1s in the same manner that medications for other chronic diseases, such as diabetes and heart disease, are included as part of the pharmaceutical benefit.

The process of repealing this inappropriate language can be accomplished by your administration without the need for legislation. The current Ohio regulations are woefully outdated, failing to acknowledge current scientific research and available pharmaceutical innovations that have a life-changing impact on those living with obesity.

By using your administrative authority to repeal the outdated code language, the state of Ohio can then begin to engage with manufacturers and take advantage of negotiated solutions aimed at mitigating the financial impact of GLP-1 coverage. The result: a healthier population that uses fewer medical services and therefore saves money.

Gov. DeWine, we hope you will consider this request with the urgency it deserves. There is no need to wait on the Ohio General Assembly to act – you have the power to repeal the prohibitory administrative code language right now. In doing so, you will change the trajectory of Ohio’s obesity statistics and place your state on a path towards improved health, chronic disease prevention, lower health care costs, and improved productivity.

Obesity is not a choice. It is a chronic disease that requires committed, long-term treatment. Untreated obesity is linked to the development of type 2 diabetes, heart disease, cancers, and other serious, chronic, and costly diseases. 25 percent of all adult Ohioans have diagnosed diabetes or prediabetes. Inaction only makes matters worse.

Please contact the Obesity Action Coalition Policy Advisor, Chris Gallagher, at [email protected], or the American Diabetes Association’s Senior Director of State Government Affairs, Gary Dougherty, at [email protected] with any questions or to schedule a meeting to further discuss our request