Maryland Republicans often accuse Democrats of overspending taxpayer dollars and failing to bring in enough revenue in return. But on Monday, Senate Minority Leader Steve Hershey asked his chamber colleagues to pass a bill that would place a $449 million price on annual Medicaid funds, placing a heavier burden on taxpayer dollars used to cover healthcare costs and increasing spending at a time that lawmakers are scrambling to eliminate the $1.4 billion shortfall.

Hershey’s bill would expand the amount Maryland can spend to help individuals pay for weight-loss medication and cover intensive behavioral therapy, bariatric surgery, and any medication approved by the U.S. Food and Drug Administration (FDA) for individuals dealing with obesity, if passed. Currently, Medicaid covers the cost of weight loss drugs — such as Ozempic, Wegovy, and Mounjaro — only when an individual is diagnosed with obesity and other health issues such as sleep apnea or cardiovascular disease. If an individual is only trying to combat obesity, Medicaid will not pay for their weight loss medication.

During a Senate floor debate, Hershey said this is necessary to drive down healthcare costs because Maryland could end up with a “healthier population.”

“This is on the lines of preventative care,” Hershey said. “People with obesity are more prone to have other diseases, such as diabetes, hypertension, [and] things that we had talked about in the committee. There has been evidence that shows that as people lose weight, those types of comorbidities decrease.”

Democratic Sen. Arthur Ellis said that Marylanders could shoulder more Medicaid costs because the federal government will slash about $1 trillion in Medicaid spending over the next 10 years. Medicaid is a joint state and federal program that provides free or low-cost healthcare coverage to low-income individuals.

“What’s the likelihood, with all the cutbacks coming from the federal government on Medicaid, of that money coming from the Trump administration to Maryland?” Ellis asked

“50-50,” Hershey responded.

White House spokesman Kush Desai said Maryland will be in a position to cover the cost of weight loss drugs.

“Thanks to President Trump’s Most-Favored-Nation drug pricing push, some of the most popular GLP-1 weight-loss drugs are available right now on TrumpRx.gov and, soon, to state Medicaid programs at dramatically discounted prices — with some variants up to 85 percent cheaper than they were before,” Desai wrote in a statement to The Baltimore Sun.

The federal government pays for almost 60% of Maryland’s Medicaid costs. The state’s portion of Medicaid funding comes mostly from the general fund, which is money collected from individual income and sales taxes, among other fees. The current iteration of Gov. Wes Moore’s budget proposal, which has passed the Senate and is being considered in the House, recommends trimming spending on general funds.

“If we pass this bill, it’ll sit out there as a $449.4 million annual potential cost, which will get stuck against this structural deficit because all these bills we pass with this price tag add to the structural deficit and makes us look like idiots because our deficits go so much higher,” Ellis said, noting that Maryland’s revenue, in recent years, hasn’t yet outpaced its expenditure. “But based on ‘ifs’ [it] makes us look like fools.”

But, Hershey said, there “could” be spending cuts made to accommodate the cost of his legislation. Additionally, “We [have] passed a lot of bills that have special funds for them, that create a new fund, and it says that the governor may include money into this fund.” Special funds are taxpayer dollars earmarked to specific goals.

At the end of the floor debate, the Senate pushed Hershey’s bill for final consideration and a vote, which will likely take place this week. Sen. Clarence Lam also joined Hershey’s bill as a sponsor, signaling that Democrats may support the legislation.

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