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It’s an ugly piece of legislation. Explaining why is tricky, but bear with me.

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The point of workplace wellness programs is to discriminate among employees. Those who adhere to the wellness program—whether by filling out a health assessment, taking a blood test, or attending smoking-cessation classes—pay less for their health coverage. Those who don’t, pay more.

At the same time, a bunch of federal laws aim to stop discrimination in the workplace. HIPAA is one such law: it prohibits employers from asking employees to pay more for their coverage based on their health status. Many wellness programs couldn’t exist in the face of that prohibition.

So, in HIPAA, Congress partly exempted wellness programs. They were allowed to discriminate a little bit based on health status. The ACA expanded HIPAA’s carve-out. Today, wellness programs can ask employees who don’t adhere to a wellness program to pay up to 30% more for their health coverage.

But Congress has never fully resolved the tension between federal antidiscrimination law and wellness programs. Take the Americans with Disabilities Act. It says that employers can’t ask their employees to take a medical exam, including a medical history, unless doing so is “voluntary.”

… read more

image: By Zephyris at the English language Wikipedia, CC BY-SA 3.0,

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The Incidental Economist

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