Kalamazoo County employees using GLP-1 weight-loss medications will pay up to $200 a month starting with the 2027 health plan.
The Board of Commissioners’ Committee of the Whole voted 8-0 Aug. 5 to keep the medications covered under the county’s self-funded health plan, but to add a flat $200 monthly copay — up from little to no out-of-pocket cost today — when the drugs are prescribed for obesity. Commissioner Abigail Wheeler was absent due to illness and did not vote.
HR Director Sharon Brown told the board GLP-1 coverage is projected to cost the plan about $1.6 million this year. Brown said keeping the drugs covered as currently structured would drive an estimated 11.5% increase to 2027 health insurance premiums, compared to roughly 5.5% if the drugs were dropped from coverage entirely.
Brown presented three options: raising the employee copay (either a 50% coinsurance split or a flat per-fill amount); dropping the drugs from the plan and reimbursing employees for direct-to-consumer purchases instead; or eliminating coverage and redirecting the savings toward general wellness programs. She told the board the reimbursement option carried legal risk under IRS rules and that “this is a really bad idea to try to do for 27,” per her benefits advisor’s recommendation.
A first motion, from Vice Chair John Taylor and supported by Commissioner John Gisler, proposed a 50% coinsurance split rather than a flat copay. Commissioners Dale DeLeeuw and Monteze Morales said a 50% split would still be too costly for employees on the county’s lower salary tiers. The motion failed on a roll call vote, and Taylor withdrew it.
DeLeeuw then moved to adopt the copay option at a flat $200 per month instead of a percentage split, supported by Morales. That motion passed 8-0.
Several commissioners described the $200 copay as temporary. Taylor said the board would need to revisit the county’s overall approach to the drug’s cost within a year, telling colleagues the county is currently “spending 2% of our overall operating budget on one prescription drug.” Gisler and Commissioner Tami Rey said they were supporting the change as a stopgap rather than a long-term fix.
Brown told the board Grand Rapids, Ingham, Kent, and Oakland counties also cover GLP-1 medications for obesity, while Genesee and Ottawa counties do not. The county does not currently require prior weight-loss program participation or other screening before covering the medications, unlike some other counties’ plans.
