The Patient Protection and Affordable Care Act’s use of modified community-based rating and its outlawing medical underwriting has drawn criticism that the policy unfairly subsidizes those who lead unhealthy lifestyles and drive up costs. While individual and small group market health plan issuers can no longer base premiums on an individual’s lifestyle or health status for coverage beginning January 1, 2014 or later, a type of risk rating is available to employers under the law. It’s in the form of “workplace wellness” programs that allow employers to reduce what employees have to pay toward their health insurance or offer financial incentives if participating employees meet specified health status metrics such as weight, BMI, blood pressure and serum cholesterol.
Studies of the effectiveness of these programs yield mixed results, suggesting they have only limited influence on the health status of employees, this Atlantic article indicates. Since engaging in health promoting activities is largely driven by peoples’ personal choices and circumstances, I believe the best thing employers can do is to maximize their employees’ ability to make healthy lifestyle choices rather than essentially bribing them to do so. That means affording them the ability to devote the necessary time to properly engage in them.
Need a speaker or webinar presenter on the Affordable Care Act and the outlook for health care reform? Contact Pilot Healthcare Strategies Principal Fred Pilot by email