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Both the Senate and House health care bills propose incentives to boost corp
Both the Senate and House health care bills propose incentives to boost corp
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2023-08-06
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Both the Senate and House health care bills propose incentives to boost corporate wellness programs that aim to help employees stay healthier and to control a company’s insurance costs. But those programs were slowed down with the recent enactment (颁布) of a law that generally prohibits employers and insurers from asking workers about their family medical history.
Workplace wellness programs are commonplace these days. More than half of employers offer smoking quitting or weight management programs, according to a 2009 survey by Aon Consulting. More than a third have on-site fitness centers.
The first step in enrolling an employee in any wellness program is typically to ask him to complete a health risk assessment containing a dozen or more questions, including some about the employee’s family history of medical conditions.
But the Genetic Information Nondiscrimination Act of 2008 makes it illegal to discriminate on the basis of genetic information in health coverage. That means that health plans can’t use genetic information to make coverage decisions or set health insurance premiums. Insurers and other companies that implement new wellness programs for employers are no longer permitted to ask people about their genetics or family history in health risk assessments if the answers are tied to any sort of reward, like a premium discount.
However, financial incentives—from cash bonuses to reduced premiums—are a popular tool to encourage employees to fill out health questionnaires and participate in wellness activities. Legislators had hoped to expand those incentives. The Senate health reform bill, for example, would permit employees who participate in wellness programs and who meet certain health targets to receive discounts of up to 50 percent on their health insurance premiums.
Though employers may feel annoyed at the new restrictions, some experts say privacy considerations should come first. Wellness programs, they maintain, can be just as effective without knowing whether high blood pressure or heart disease runs in the family.
Health care spending continues to climb, growing 5.7 percent last year, to $2.5 trillion, the Centers for Medicare and Medicaid Services announced recently. Although public programs made up the bulk of the increase, private employers are desperate for ways to control rising their own health care costs.
Wellness programs are one potential solution, so the new restrictions "were somewhat of a disappointment to employers," said J.D. Piro, who leads the health law consulting group at benefits consultant Hewitt Associates.
Still, he acknowledged, "You can certainly run an effective program in the absence of that information." Patient advocates agree. Although family history is a critical part of a person’s disease risk profile, the actions promoted in wellness programs—quitting smoking, exercising, eating a healthy diet—are beneficial no matter what’s in your DNA.
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