This article is extremely inaccurate and misleading, and appears very biased (“Wellness incentives under fire,” Nov. 16, p. 12). The reporter writes: “Under current wellness program regulations, set in the Health Insurance Portability and Accountability Act of 1996, health plans can offer financial rewards to workers who achieve a certain health goal up to 20% of the cost of the employee's share of the premium.” This is wrong. The voluntary wellness program exceptions to the HIPAA nondiscrimination rules she indirectly references allow for rewards up to 20% of the total costs to provide the medical program. “The HHS secretary would have discretion to increase the reward to up to 50% of total cost per worker.” This is wrong. The discretion is to increase the reward to up to 50% of the total costs for all participants, which may include spouses and dependents. “But because the Senate amendment allows employers to cost-shift the total cost of the premium—including the employer's share—over to the unwell worker …” This is wrong. The Senate amendment does not address shifting “total costs.” It simply proposes to increase the current 20% allowable rewards to 30% with an option for HHS to raise them to 50%. “The Senate amendment does provide waivers for participants who cannot meet the applied standards because of a medical condition.” This was codified into HIPAA years ago. The caveats are “medically inadvisable” and/or “unreasonably difficult” because of a medical condition, and all plans have to communicate that an alternative to qualify for rewards is available (rather than meeting health improvement goals). The reporter goes on to paraphrase George Huntley, board chairman of the American Diabetes Association, this way: “There is no oversight of such programs, so employers could continuously move the bar for weight loss and other markers.” This is wrong. Voluntary wellness programs are overseen by the Labor Department's Employee Benefits Security Administration and other federal departments and agencies. These programs are also subject to the rules and regulations of all 50 insurance and/or commerce departments in each state where they are tied into insured healthcare products. Finally, the reporter quotes Mr. Huntley saying: “What business is it of your employer to know what your blood sugar level is?” A strong argument could be made that, since employers pay for 70% to 90% of all healthcare (and healthcare coverage) costs in America for 180 million people, it is their business. These programs improve health; they do not discriminate. Perhaps the reporter could try again ... and be more accurate and objective.
Steve IgnatinRegulatory analyst, public policyNational Business Group on HealthWashington