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Wellness Not Faring Well

Campaign Ready to Strike Provision From Reform Bill

Innocuous sounding “wellness programs— that many employers would like to see included as part of health care reform legislation have sparked a lobbying campaign by disease groups, consumer organizations and unions. They argue that the programs could potentially make health insurance unaffordable for some people and could compromise workers’ privacy.

The Senate Health, Education, Labor and Pensions Committee’s health care reform bill, which is set for markup today, could include amendments that would

expand employer wellness programs and allow companies to charge up to 50 percent more for premiums to certain workers who do not participate in the programs. More than 40 organizations, including the American Cancer Society’s Cancer Action Network and the AFL-CIO, have stepped up their efforts in opposition.

“I know that all the groups are making calls to the Members and are working it pretty hard, and some are activating the grass roots,— said the cancer group’s top lobbyist, Dick Woodruff. “If this gets introduced this week, it’s going to escalate.—

Senate aides familiar with HELP Committee negotiations said the idea is definitely under consideration, garnering support from Republicans and even some Democrats. But some members of the committee are concerned that such a provision could have unintended consequences, especially for people with pre-existing conditions or those who are unable to control unhealthy habits, such as smoking.

“No one wants to see prevention and wellness efforts expanded more than I do, but this must be done right,— Sen. Tom Harkin (D-Iowa), a HELP Committee member, said in a statement to Roll Call. “Participation must be voluntary, and any premium variations must be reasonable, and contain safeguards to protect our most vulnerable citizens, including ensuring that wellness programs contain no barriers to participation. Our intention with health reform is to reduce the number of uninsured in this country and create positive incentives to stay healthy.—

Woodruff said insurance companies already can charge up to 20 percent more to employees who do not participate in wellness programs or to those employees who do not meet certain wellness targets (such as quitting smoking).

“Any time you increase the cost, it puts up a barrier,— Woodruff said, noting that if premiums are too high for workers, then they will end up uninsured. “It just flies in the face of what we’re trying to accomplish with reform.—

He added: “We’re working very hard to persuade Senators that this is not a good idea. We remain concerned. Republicans have said they’re planning to do amendments. Democrats have suggested they could possibly support it.—

JoAnn Volk, legislative representative for the AFL-CIO, said all the groups with concerns are supportive of workplace wellness programs. “It’s just a matter of how this stuff gets defined,— she said. “You cannot call it voluntary where to opt out means you have to pay a higher premium.—

Rebecca Fox, executive director of the National Coalition for Lesbian, Gay, Bisexual and Transgender Health, said the community that she represents is often disproportionately targeted by marketers of cigarettes. Plus, she said, gay and transgender people have extra kinds of pressure from discrimination that can lead them to smoke. “It’s important to realize that unhealthy behaviors don’t happen in a vacuum,— she said. “There are positive ways of helping people without punishing them for that behavior.—

But business organizations say labor and other groups’ opposition is unfounded.

“Either they don’t know what they’re talking about, or they’re full of it,— said James Gelfand, senior manager of health policy for the U.S. Chamber of Commerce, which supports the idea of allowing employers to increase rates up to 50 percent for employees who do not participate in wellness programs to get diseases like diabetes under control.

The chamber does not, however, support higher rates for employees who join the programs but are still unsuccessful at managing weight or disease conditions, Gelfand said.

“People don’t have to quit smoking or get their diabetes under control, they have to try the programs that their employers offer,— he said. “You can spend all the money you want in creating these programs that will help people be healthy, but the take-up of these programs is terrible. Money talks.—

Gelfand conceded that his opponents’ lobbying message appeared to be resonating with Members.

“There’s a lot of misinformation and scaremongering coming out from the groups,— he said. “It’s probably made this a very difficult lift on the Hill.—

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