Obesity and Health Insurance Premiums

scaleDoes your employer offer wellness programs? Sometimes, employers determine the cost of a worker’s health insurance premium based on participation in this type of incentive program. In some cases, premium cost is connected to reaching certain health goals. Is this a fair way to treat workers who are obese?

It has been said, for many years, that America has an “obesity epidemic”. In 2011, a study found that 32% of American men, and 35% of American women, were obese. If those trends continue, some health experts predict that about half of all the men and women in America will be obese by the year 2030.

Not everyone who is considered to be obese is unhealthy. It’s possible to be what is referred to as “metabolically healthy”. In other words, the person doesn’t match the shape of the supermodels in the magazines, and is technically obese according to the BMI charts, but does not have any health issues that are commonly related to obesity.

On the other hand, it is also possible to be obese and unhealthy. A person who is obese has an increased chance of developing hypertension, high cholesterol, diabetes, and heart disease. Obesity can cause other health conditions, such as asthma, to get worse.

Most of us have had a point in our lives where we were trying to lose weight. It isn’t easy. Sometimes, there are underlying health issues that cause a person to have difficulty losing weight. For example, a thyroid condition could affect a person’s ability to lose weight.

Obviously, people who have chronic health conditions are going to require more visits to doctors, and may need more prescription medications than do people who are healthier. Extra health care means extra cost. Employers who offer health plans to their workers want to lower the costs of it as much as possible. This has led to what is called a “wellness program”.

This is where things start to get controversial. Some wellness programs entice workers to make healthier choices by offering prizes, (like tickets to a movie, or a baseball game) to those who choose to participate. No penalty is incurred by workers who choose not to participate.

Other employers require workers to participate in the wellness program. Those who achieve the health goals in a wellness program may be offered a lower health insurance premium. Workers who don’t achieve the goal end up with the original premium cost, which will be higher.

The Affordable Care Act prevents people from being charged more for health insurance due to a pre-existing condition. Some employers have found a way to get around that rule. Technically, they aren’t charging workers who are obese more for their premium. They just aren’t offering them a discount. This isn’t how that rule was intended to be followed!

NPR has an interesting discussion about this issue. What do you think? Is it ok to charge people (who may have a pre-existing condition) a higher amount for health insurance than their healthier co-workers?

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