In the United States, the majority of working age adults receives health coverage through employer-sponsored health plans. As the cost of those plans has risen in recent years, employers are looking for ways to hold the line. Dropping those plans and telling employees to buy their own coverage has multiple downsides for large employers. They would lose a major income tax deduction and large employers would face penalties under the Patient Protection and Affordable Care Act for failing to offer coverage to full time employees and their child dependents. Plus they worry doing so would run the risk of making it harder to recruit and retain staff.
Looking for options to shed health benefit costs, some large employers are turning to “workplace wellness” programs that monitor employee health status and enforce health maintenance with rewards and penalties applied to employee premiums and cost sharing.
“Employers are carrying a major burden of healthcare in this country and are trying to do the right thing,” said Stephanie Pronk, a vice president at benefits consultant Aon Hewitt told Reuters in this article on wellness programs. “They need to improve employees’ health so they can lead productive lives at home and at work, but also to control their healthcare costs.” As the Reuters piece reports, critics see wellness programs as a thinly veiled effort to shift health plan costs to employees, pointing to studies that indicate wellness programs don’t produce meaningful reductions in health care utilization. And the Obama administration is taking some large employers to court, alleging they are violating the wellness program rules of the Affordable Care Act that allow employers to offer voluntary programs by mandating all employees participate.
Princeton University health care economist Uwe E. Reinhardt and other critics view wellness programs as the medicalization of the workplace, arguing employers shouldn’t be in the business of monitoring the health of their employees. However as Pronk suggests, since employers are paying the bill when they need medical care, they have a natural stake in employee health. The outcome of this debate could well determine the future of employer-sponsored health coverage in the U.S.
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