HealthZette

Use Our Wellness Program, or Lose Your Coverage

Health care insurance often tied to mandatory participation

The term “employee wellness program” once had a nice, friendly, relationship-building ring to it.

It evoked a cheerful, efficient picture: workers walking together at lunchtime, exercising in the company gym, getting flu shots in the company medical’s department or taking part in health screenings, all courtesy of the corporation.

Participation was optional and mutually beneficial: The employee received reductions in health care costs and/or financial incentives to participate. And the employer drove up productivity and profits by boosting employee health and limiting workers’ sick days.

Those days are, alas, nearly gone. Today, many companies are putting a stranglehold on employees, demanding they participate in wellness programs or risk losing their health care coverage.

A new Big Brother is here — and he’s got a stethoscope around his neck and your blood pressure numbers in his hands.

Concerned with an increasingly unhealthy American workforce, employers spent a record $693 per employee on wellness initiatives last year, up from $430 the previous year, according to data compiled by Fidelity Investments.

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“Voluntary” participation is now morphing into “mandatory” compliance in many cases, in an ironic imitation of Obamacare’s control of health care that has the government taking businesses to court and limiting the personal freedoms of Americans in the workplace.

Scotts Miracle-Gro, for example, bans employees from smoking, whether on company or personal time, and it will test workers for nicotine. Cadmus Community Corp., of Richmond, Virginia, requires employees and their spouses to submit to health-risk assessments to obtain health insurance.

At Iowa-based Principal Financial Group Inc., workers have access to health screening programs, which are optional — but employees who participate receive a discount.

Several federal courts have declared the mandatory health screenings perfectly legal.

In a 2015 case filed by the Equal Employment Opportunity Commission on behalf of an employee of a Wisconsin company who refused the health screenings, the government argued the employer’s wellness program didn’t comply with the Americans with Disabilities Act, which limits companies from requiring medical exams or personal health information from workers.

[lz_bulleted_list title=”Essential Elements of Well-Being” source=”Gallup-Healthways”]Purpose: liking what you do each day and being motivated to achieve your goals|Social: having supportive relationships and love in your life|Financial: managing your economic life to reduce stress and increase security|Community: liking where you live, feeling safe, and having pride in your community|Physical: having good health and enough energy to get things done daily[/lz_bulleted_list]

Denying employer-sponsored coverage if screenings aren’t completed by the employee crosses the line from voluntary to coercive, the EEOC contended in court.

A federal judge in Madison, Wisconsin, disagreed, ruling on Dec. 31 that employers can deny coverage without violating the ADA, as long as the data collected from the wellness program is used for the purposes of overall health coverage. This follows on the heels of a 2012 case, in which a federal appeals court in Atlanta found in favor of an employer as well, using the same reasoning about the ADA to affirm a lower court ruling.

A legal precedent is being created. As Christopher Kuczynski of the EEOC told npr.org, “Limited incentives are permissible … as long as the maximum incentive for participating doesn’t exceed 30 percent of the total cost of coverage.”

“Incentive” must be in air quotes, because these policies are not incentivizing but penalizing.

Employees should be able to choose whether they participate in health programs, but their health care coverage should not be dependent on it. The nature of one’s health is personal and private, and should be kept entirely separate from the workplace.

Yet in some companies, it’s either participate in the medical screenings that the company provides, or move to a more expensive government health care set-up.

Do wellness programs even work?

About 60 percent of U.S. companies now offer some kind of wellness initiative, up from just 36 percent in 2009, according to the Rand Corp. Implementing such programs has grown into a $6-billion-a-year industry, according to study results released in 2014 by Rand, which tracked PepsiCo’s employee wellness program for six years.

The Rand study results were mixed, with benefits seen in chronic illnesses but not in health maintenance. The study found that helping employees manage chronic illnesses saved $3.78 in medical costs for every dollar PepsiCo invested in the effort. This disease management — cutting the number and length of hospital stays — accounted for about 87 percent of PepsiCo’s total cost savings. Still, only about 13 percent of employees participated.

Among the far larger number of PepsiCo employees who were healthy and trying to maintain that through diet and exercise, the results were less impressive.

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“The lifestyle-management component of the program — while delivering benefits — did not provide more savings than it cost to offer,” said Soeren Mattke, the Rand senior scientist who led the study, Rand.org reported.

With these unimpressive results for the average healthy person, why the push to infringe on employee rights?

“You’re seeing a real tension to basically ‘incent’ people to live healthier lives so that they can use insurance less, and lose less days at work, and be more productive,” Paul Secunda, a professor of law at Marquette University who specializes in labor and benefits law, told Bloombergnews.com. “On the other hand, there’s the medical privacy concerns of individuals.”

“My employer wouldn’t like to hear this, but I would not participate in any sort of ‘medical data collecting’ through any wellness program they offered, because I don’t know who has access to it, and how they might use it against me,” said one New York telecommunications professional. “What if they said, ‘Oh, he has high blood pressure, so we can’t give him that big project?’ That is my health business to handle with my own doctor.”

“This is an almost laughable example of why big government doesn’t work,” Amy Ridenour, chairman of The National Center for Public Policy Research, told LifeZette. “On the one hand, Obamacare pushed corporations into nannying the health care of its workers. On the other, the same federal government that adopted and administers Obamacare claims it is illegal for corporations to nanny its workers.”

She added, “One almost sympathizes with the big corporations that are upset with this decision — until one remembers that big corporations are in bed with big government half the time.”

This article has been updated.