This item was distributed by Progressive Review in its daily UnderNews newsletter:

September 28, 2015

Obamacare Discriminates Against Heavy People

Economic Hardship-–A 2013 report by ConscienHealth, a consultancy, found that 16 percent of employers require wellness program participation, including medical screenings, for access to full health benefits. Of these, 67 percent set goals for weight and/or other health indicators linked to obesity (weight, blood pressure, cholesterol, diet). But 59 percent said that their companies didn’t cover any evidence-based treatments for obesity, like fitness training, dietician, or medical weight loss clinics.

Penalizing employees for pounds is perfectly legal. Under provisions in the Affordable Care Act, 2014, employers can charge employees an extra 30 percent of the total cost (employer and employee portions) of individual or family health benefits coverage if they don’t meet specific wellness goals, including body mass index. This is up from 20 percent, which was imposed in 2006 and permitted under the Health Insurance Portability and Accountability Act regulations. Prior to 2006, employees couldn’t be penalized for missing a wellness target. “You could offer them nominal incentives to engage in activities like participating in a class, but you never could penalize them for actually smoking or not losing weight, or having high blood pressure,” said Karen Pollitz, a senior fellow at the Kaiser Family Foundation, in Washington, D.C.

Although the law requires employers to give employees an alternative way to avoid the penalty if he or she can’t meet the mandated health goal, the employee might still end up spending money. For instance, the employer might set a weight loss goal that the employee still can’t meet, or suggest the worker attend a fitness class. Those who opt out would accrue some financial penalty.

Yet studies have turned up scant evidence proving these programs save employers money. In a March 2013 study in Health Affairs, researchers reviewed randomized controlled trials of workplace wellness programs. They found that any savings to employers were most likely the result of cost shifting to employees with higher health risks, like obesity. A November, 2014 report in the same publication noted that these programs “increase, rather than decrease employer spending on health care with no net health benefit. The programs also cause over-utilization of screening and check-ups in generally healthy working-age adult populations, put undue stress on employees, and incentivize unhealthy forms of weight-loss.”

In fact, many critics feel that what it really amounts to is thinly veiled fat discrimination.