The 'Wellness' Plan Discrimination Loophole

Many of us need a little extra help when it comes to sticking to an exercise routine or kicking our unhealthy habits. If our employers want to help us get healthy, that isn't so bad, right? We spend a third of every weekday at work, so a healthy workplace could really make a difference. But what if our employers decide to "help us" by charging us more-much more- for our health insurance?

So-called "wellness" programs that impose health insurance surcharges or discounts based on whether workers lose weight, quit smoking, or reach other health goals are popping up in workplaces around the country. For example, North Carolina state employees are dismayed to learn that they will soon be paying more for their health care if they don't lower their BMIs (Body Mass Index) and refrain from smoking. Currently, federal rules allow employers to charge their workers up to 20 percent more for their health insurance premiums if they fail to meet health goals. Some members of Congress want that amount to be increased to 30, or even 50 percent.

For example, the average annual premium for family coverage was greater than $13,000 in 2009. A 50 percent premium surcharge for a family's failure to lose weight or quit smoking could raise premiums to almost $20,000 a year.

Programs that punish people-people who may be genetically predisposed to weight problems, people who may have little access to gyms or safe exercise spaces, and people who frankly may not want their employers subjecting them to invasive measures of weight, blood pressure, and other privacy-invading tests-achieve the exact opposite of what health reform strives to do for Americans. That's why groups such as the American Cancer Society, the American Heart Association, and the American Diabetes Association oppose amendments that will sanction even higher premium penalties than the law already allows. 

Polls and surveys have been unequivocally clear that Americans want Congress to prohibit the practice of charging higher premiums to people because they are in less-than-perfect health or have a pre-existing condition. Yet these so-called "wellness" plans open the door for employers and insurers to continue this insidious discrimination. Let's be perfectly clear: "Wellness" programs that charge people more based on health status indicators-just like pre-existing condition exclusions and higher premiums based on health status underwriting-defeat the health reform goal of quality, affordable coverage for all. In fact, rather than help people improve their health, these types of wellness plans make coverage unaffordable for the very people who need it most.