Cut to GLP-1 coverage prevents personnel cuts this year, but fiscal challenges ahead for Chelmsford

CHELMSFORD — After a sharp increase a year ago led to layoffs, the proposed fiscal 2027 budget for the town of Chelmsford saw a more muted increase to its health insurance premiums for employees, thanks in part to a cut to coverage of GLP-1 drugs for non-diabetics.

Between the town’s general budget, and the budgets from Chelmsford Public Schools and Nashoba Valley Technical High School, Cohen said he is proposing a “level-staffing, level-service budget,” or as close to that as the town can get in this economy. This comes out to $176.4 million for the fiscal year between the town and two school districts, with CPS’s budget increasing 3.3% to $78.15 million, and the Nashoba Tech assessment for Chelmsford increasing 6.5% to $4.32 million. Last year Town Meeting approved a budget of $168 million.

“There is no new program, there is no expansion of personnel or staff,” said Cohen.

Last year, Cohen had approached the Select Board with a budget that included a 17.5% increase in the cost of employee health care premiums, a sharp rise that contributed to a series of layoffs that hit town staff. Cohen said he had been bracing for another sharp spike in health insurance premium costs, to the tune of about 13%, but that figure was able to be dropped to 8% thanks to a cut to coverage for GLP-1 drugs.

“What ended up happening is that they ended up eliminating the GLP-1s … for non-diabetic patients,” said Cohen. “That cut our health care premiums by 5%.”

GLP-1 drugs were originally intended to help those with diabetes by managing blood glucose levels. In recent years these drugs have surged in popularity, not for their treatment of diabetes, but because they come with a side effect of inducing weight loss. Now they are more commonly known under brand names like Ozempic, Wegovy and Zepbound, and they are often marketed for their weight loss effectiveness.

Without the cut to insurance coverage for these drugs as weight loss treatments, Cohen said there would have been cuts to services and personnel in town, as there were last year. He said the state Group Insurance Commission is likely to make the same cut to coverage of GLP-1 drugs, as have the group insurance programs for other cities and towns.

“That is the big change, and no one enjoys that, making that situation, but that is the reality because the actuarial value on that was just a big question mark, and created a financial burden,” said Cohen.

He noted the town spent $839,000 on GLP-1 drugs in calendar year 2025, when the year prior that number was just $251,000.

Another area that helped the town avoid cuts, Cohen said, was the school budget, which he said was originally proposed to him with a $3.5 million increase from last year, but Superintendent of Schools Jay Lang lowered the request to $2.5 million.

While the town may avoid the worst of the potential cost increases it was facing for the upcoming budget, Cohen said the situation will not continue to be sustainable.

“We’re not going to have the GLP-1s to eliminate a year from now, and at some point with inflation you’re not going to be able to just cut, cut, cut,” said Cohen, noting that conversations about covering future deficits are already taking place.

“You are going to be looking at issues of trash collection and fees and so forth in the years ahead, because those are the tough choices you are going to have to deal with for the community,” he said.

Select Board member Aaron Cunningham said the town this year “got lucky with another one-time event,” by being able to save money on a cut to insurance coverage.

“At some point we’re going to have to start paying the piper, and the reality is, and I want to be clear, nobody around here sits here and says, ‘How can we raise taxes?’” said Cunningham. “We raise taxes up to the legal limit because we have to fund operations. But at some point, with costs going up, we’re not talking about trimming fat here, we’re talking about cutting off limbs, and we need to operate the town government, we need to operate our schools.”

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