Ozempic & Health Insurance Crisis

Recently, a healthcare insurance agent described an alarming situation in northern Idaho. He said that approximately 7,000 people could be dropped from their health insurance coverage due to the alarming increase in the cost of drugs. One of the culprits may be the new miracle weight loss drugs.

Nearly 73% of Americans are either overweight (31%) or obese (42%). Ozempic a new GLP-1 hormone medication was originally approved to treat diabetes but was also found to have an amazing effect on weight loss.

Expensive Weight Loss Drugs
Recall that most plans have a deductible. Once it’s reached the insurance company pays for the remaining costs through year end. Ozempic and other GLP-1 drugs have exploded in use in the past 2 years. The cost to the consumer varies depending on insurance coverage. It’s not uncommon to pay $1,000 a month.

As an example of the problem, if Ozempic costs you $1,000 per month and you have a $5,000 deductible (as many people do) it won’t take long to reach the deductible. The insurance company pays for the remaining doses.

The problem is that many companies are going bankrupt paying for these newer drugs and are stopping coverage for all GLP-1 drugs. Consumers will be forced to pay out of pocket costs anywhere between $1,300 to $2,000 a month.

How It Works
Ozempic is one of many GLP-1 hormone injection medications. They work by stimulating the pancreas to release more insulin which lowers blood sugar. They also slow food from leaving the stomach so one feels fuller longer. Weight loss ensues immediately.

The main side effects from rapid weight loss may be muscle loss and loss of fat deposits more noticeable around the face. There is a concern for increased risk for thyroid type cancers as well. Further, aspiration pneumonia may occur if food isn’t completely eliminated from the stomach before anesthesia.

Obama Care Extensions Issue
The other thing impacting Americans is the loss of insurance subsidy support. Lower income people qualify for Medicaid, seniors have Medicare and most employed workers have employee healthcare. The issue arose for those working without access to healthcare insurance. Hence the Affordable Care Act was born also known as Obama Care.

The cost was supposed to be determined by a sliding scale based on income. During the COVID pandemic the sliding scale payment system was altered but set to return once the pandemic was over in 2025. Those who have a higher income pay more while those with a lower income pay less.

However, in the interim healthcare costs have skyrocketed! Someone must pay those costs: either the consumer, the insurance company or this debt-ridden government (taxpayers). But no one is looking at how to control the outrageous costs!

On A Personal Note
Last week I called my local congressman. I shared a solution to this crisis that I’ve seen work. In 2000 our heart institute in Chicago bought a new technology that could detect subclinical atherosclerosis or plaque buildup years before someone had a heart attack.

The Coronary Artery Calcium Score noninvasive test takes images of the arteries that surround the heart looking for calcium deposits which are a part of inflammation. I’ll write more about this test next month. The original cost was $400 and not covered by insurance. Other hospitals began purchasing this technology. People could determine which hospital had the best price and go there. The cost plummeted! In February Heart Month of 2009 you could get this test for $50.

Further, I sat next to a health insurance executive on a plane and asked him why we can’t buy health insurance like car insurance? Most of us don’t have car insurance for oil and tire changes. We pay those ourselves. I told him I’d buy a catastrophic hospital plan and pay for the smaller visits, etc. myself. I’d shop around for the best deal and get my test done at that facility. Costs would plummet!

Unfortunately, greed and corruption have infected so many of our political decisions on both sides of the aisle. Simpler solutions are unacceptable. We’re naïve to know what’s going on and even more resistant to get involved and change things. It’s a mess!

Finally, remember there are risks with any medication. Do your homework and ask a lot of questions. Pray for wisdom for our leaders on both sides of the aisle to come up with solutions that are fair and reasonable for all citizens. We also pray that 2026 will bless our nation with peace around the world and laws that are fair and just for all people. Happy New Year to you and yours…Jennie

I am a firm believer in the people. If given the truth, they can be depended upon to meet any national crisis. The great point is to bring them the real facts (Abraham Lincoln).

References

“New CDC Data Show Adult Obesity Prevalence Remains High,” CDC Newsroom, (September 12, 2024). https://www.cdc.gov/media/releases/2024/p0912-adult-obesity.html

1. Puckey, “How Much Does Ozempic Cost With or Without Insurance?” Drugs.com (November 18, 2025). https://www.drugs.com/medical-answers/what-ozempic-cost-insurance-without-insurance-3578680/

I’m a Christian nurse who helps people navigate the murky waters of healthcare

Author of Wake UP Call 911: It’s Time to Reduce your Risk for A Heart Attack and Stroke (2015) and Helping the Hurting: Nursing Ministry in the Body of Christ (2022).

Paperback copies of both books for sale. Email me for details at:  ask@jenniejohnsonrn.com.