Wellness Programs: Coercion?

Unlike the citizens of most other countries, most American adults with health insurance get it through their employers. This situation has led to the development of workplace wellness programs, in which some employers offer their employees incentives to improve their health — and, hopefully, consume less health care, saving the company money in the process. While workplace wellness programs have been around for decades, they’ve been on the rise in recent years — in part because of supportive treatment by the Affordable Care Act (“Obamacare“).

Many people who study the issue believe that workplace wellness programs benefit both employers and employees, saving money for both groups and improving employees’ health in the process. Typically, employers offer a financial incentive to encourage participation — either a fixed bonus amount, or a percentage discount on health insurance premiums. Earlier this year, the Equal Employment Opportunity Commission — the federal agency that oversees workplace wellness program rules — announced that starting next year, employers will be allowed to offer incentives as high as 30% of the cost of health insurance premiums.

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In response to the Equal Employment Opportunity Commission’s new rule, AARP — the advocacy group for older Americans — filed a lawsuit on Monday that seeks to put the rule on hold, as noted by The New York Times. The suit alleges that by allowing such large financial incentives by employers, the Commission is allowing them to coerce employees into sharing confidential medical information. Typically, workplace wellness programs require participants to complete a health assessment, which some advocates fear could be used illegally by some employers to discriminate against employees with expensive health conditions.

Most wellness programs, however, are independently administered — meaning that an employer has no access to participants’ health information. In fact, most employers do this deliberately to reassure employees that their health information will remain confidential. Still, AARP objects to employees’ being pressured to share this information at all, which sometimes covers not just an employee’s health conditions, but also those of his or her spouse. In response to claims that participation is voluntary, AARP argues that many employees can’t afford not to take the financial incentive that’s offered — in effect, that employees who don’t participate are being penalized, sometimes to the tune of around $2,000 per year.

What’s your take on workplace wellness programs, and the AARP lawsuit — do you think these programs are coercive? Have you ever participated in such a program? If so, did you feel uncomfortable sharing your medical history and conditions? Do you think your participation gave you actual health benefits? Do you think that employers should be able to offer financial incentives to participate in wellness programs? If so, should there be a limit to how large these incentives can be? Leave a comment below!

  • Might want to fact-check your statement about the results of how effective wellness programs are. Turns out they’re not particularly effective. To the (actual) research! https://www.youtube.com/watch?v=48mil-jr-Pk

  • I did think it was funny when filling out my assessment for a previous employer, the month I was diagnosed with T1D. My A1c was over 13 and it was very helpful in suggesting to me that I might have diabetes (*after* I already told it I did). But yeah, talk about potential HIPAA violations — had to give them all kinds of vitals, including a blood test. Starting to go the way of Gattaca.

  • RAWLCM

    Calling employer-based wellness programs a benefit is a joke. They are mostly used as a way to penalize people who actually use their insurance. At my employer, the first thing they did was raise insurance deductibles and co-pays so the out-of-pocket expense increased by several thousand dollars. Then they said you could “earn” a discount (back down to the old levels) if you met their “wellness goals.” Employees had to submit to blood tests and BP measurements conducted by barely qualified personnel using inaccurate equipment (I think the BP cuff said “Fisher Price” on it) and the contractor would issue an arbitrary “wellness score” and arbitrary goals such as weight loss, BP reduction, glucose levels, etc. If you met those goals, you get the discount for one year. After that, they set the goals lower, even if you are healthy, and if you don’t meet the new goals, you lose the discount. Eventually the goals become impossible. My current goal is literally to cure diabetes. The glucose level I must obtain to keep my discount is that of a non-diabetic. I’m also expected to reduce my weight to a number that would give me the BMI of an anorexic. They don’t take into account my bone and muscle density, it’s only based on height. They want me at 175 lbs., but my lean body percentage is currently 215 lbs. I would have to lose bone and muscle. Worst of all, this is all done without any input from my physician. It’s clear that the entire concept is to make people with health issues pay a larger percentage of their health care costs. That’s against the law according to the ACA, but they get away with it by saying it’s not a charge, it’s a discount for the people who “meet the standards.”