The vote followed hours of debate over how to balance the county's budget without shifting costs onto employees who rely on the drugs, which include popular brands like Ozempic and Wegovy. Rolland argued the change was necessary to close a $4.5 million budget gap that lawmakers only learned about recently.

"We need to find $4.5 million to patch a hole that we had no idea about until yesterday," Rolland said during the debate. "We cannot let Milwaukee County be financially responsible."

But opponents, including Supervisor Deanna Alexander, said the higher copay would burden workers following their doctors' orders. "It's an additional $1,320 per year imposed on people who are following the treatment plan prescribed by their physicians," Alexander said.

Supervisor Sheldon Wasserman, a physician who supports GLP-1 use, said the steep increase would be unrealistic for many county employees. Still, he acknowledged the growing expense could force trade-offs. "The amount that we're putting forward to GLP-1 could be paying for our transit system, our park system," Wasserman said. He also noted that Wisconsin ranks as the ninth heaviest state in the country, and Milwaukee County has a high rate of obesity.

"I see this is just going to explode; it's just not going to stop," Wasserman said of the costs. He expects the county's medication spending to rise to $15 million next year, meaning the debate over how to control costs is likely to resurface.

The failed amendment leaves the county searching for other ways to address the budget gap, with no clear alternative yet on the table. For now, county employees will continue to pay $40 copays for GLP-1 medications, and the county will absorb the full cost of the program.