Republican Gov. Jeff Landry made the right move for taxpayers when he vetoed a line in a bill that could have spiraled out of cost control because some active and retired state employees and public school teachers eat too much.

HB 463 was one of several money bills passed by the Legislature, this one being the annual ancillary expenses allotted to parts of state government spending from internal service or enterprise funds. He struck a single line item from it, that which would have compelled state employee coverage of semaglutide medication that can encourage weight loss as long as it didn’t cost the state money for the fiscal year.

Some took to social media to decry the decision not to cover drugs like Rybelus, Wegovy, and Ozempic. The Office of Group Benefits could have worked a deal from the manufacturers to allow for a free year’s worth, and with Louisiana having one of the highest obesity rates in the country, with that condition bringing all sorts of health problems, this benefit could reduce health plan costs down the line, which would translate soon into lower rates charged to clients than would be otherwise.

Further, last year Landry signed a bill making coverage of state residents by commercial health insurers mandatory for bariatric surgery. This expensive procedure reduces the capacity to consume voluminous amounts of food, although the surgery carries health risks and generally is recommended only at more extreme levels of obesity. Still, decades of research reveal it has pretty good success in creating significant permanent weight loss. Strategically, the law doesn’t mandate coverage for self-insured or Medicaid recipients.

Behind the scenes, a debate rages about whether obesity – typically measured by weight compared to height, although more nuanced definitions review proportion of body fat and where its may be located – is a “disease” in the sense that humans don’t have agency over its presence. Certain conditions, such as type II diabetes for which semaglutides were compounded to treat its effects, are genetic and causes of obesity, but more often simply overeating is the cause, where a subset of medical professionals argue there is some unexplained genetic reason involved.

Regardless, indisputably in many cases psychological factors predominate in decisions about how much to eat, which would argue against the citizenry providing weight loss drugs. If it’s a matter of personal responsibility, even if leaving it in the hands of individuals may foist some costs onto the public eventually, then it shouldn’t have the effect of lifting money from people’s wallets while creating a mindset that it’s acceptable to overeat that pushes obesity rates even higher.

But what really justifies the veto is that “free” isn’t really free, especially given usage statistics. Unaided, as these are monthly injections, the cost annually could be over $10,000, and they are supposed to occur for the rest of a recipient’s life. Indeed, while some states have a similar item in law, it has cost them tens or even hundreds of millions of dollars a year, and others had the coverage in law only to repeal that when costs spiraled.

In essence, the “free” initial portion is a hook – one which manufacturers would be crazed not to offer because statistics show a significant portion of those who start treatment abandon it within months, meaning entirely wasted efforts – that tries to mask the long-term fiscal consequences of taxpayer provision. Further, for those with demonstrated clinical need for weight loss, such as having type II diabetes, OGB already requires state contracted insurers to provide clients this coverage.

The idea becomes even worse when considering that evidence continues to emerge about adverse side effects with use of these drugs. The veto by Landry, who mentioned sustained costs in his message, should send a signal to legislators not to try this again.