Monday, November 9, 2009

Insurance incentives criticized

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WASHINGTON — Who could object to rewarding people who quit smoking, lose weight or start to exercise? The American Cancer Society and the American Heart Association, for starters.

Some companies now charge lower insurance premiums to workers who meet benchmarks for healthy living. The Senate's health-care overhaul legislation would expand the trend.

But some patient advocacy and health groups are worried that it would mean higher rates for less-fit Americans, possibly pricing them out of their employers' insurance plans.

"It is a way of cherry-picking," said Dick Woodruff, senior director of federal affairs for the American Cancer Society. "We are all for workplace wellness, but when you tie it to the insurance pricing system, it's a real problem."

Critics of the Senate proposal also say that giving special treatment to those who meet a company's fitness standards could undercut one of the marquee promises of the Democrats' proposed overhaul: preventing employers and insurers from discriminating against people on the basis of their health status and pre-existing medical conditions.

Safeway lobbies for plan

Under current law, companies can discount insurance premiums by 20 percent if employees meet benchmarks for weight, smoking or other aspects of their health. This year, two Senate committees, as part of the health-care overhaul, voted to allow such cuts to go as high as 50 percent.

Leading the charge for the idea is Safeway, the giant grocery store chain, which has adopted an incentive program that includes health premium reductions. Last year, the company began to offer a 20 percent premium discount to its nonunion workers who quit smoking, went on a diet, brought down their blood pressure and cut their cholesterol.

Jo Chiti, a Safeway employee who has lost about 30 pounds over the last year, said she has been swayed by Safeway Chief Executive Steve Burd's argument that health insurance should be more like car insurance. Just as good drivers should be rewarded with lower premiums than reckless drivers, Burd says, people who take responsibility for maintaining a healthy lifestyle should pay less for coverage than people who do not.

A lobbying blitz by Burd, who has traveled to Washington 11 times this year, was instrumental in the two Senate committees' decision to include the idea in their health-care bills. Senate leaders are compiling the final version of a bill they will take to the floor.

"We believe that personal responsibility and financial incentives are the path to a healthier America," Burd said in a newspaper column.

Critics in the labor movement say the incentive plan is a backdoor way for companies to cut costs by driving less-healthy workers out of the insurance group. They also fear the program will unfairly penalize people whose health status is not solely the result of behavior they can easily control.