Health insurers are allowed to charge smokers more in monthly premiums than they charge people who don’t use tobacco.
With the growing body of medical evidence linking alcohol to cancer and other deadly diseases, could insurance plans increase bonuses for people who drink?
General Surgeon Vivek Murthy wants new warning added to alcohol to alert drinkers of cancer links. Could this open the door for health insurance companies to charge more for drinkers’ health insurance?
It would be “highly unlikely” that Congress would pass legislation that would allow health insurers to charge higher premiums to people who drink alcohol, said Sabrina Corlette, co-director of the Center on Health Insurance Reforms at the McCourt School of Public Policy at Georgetown University.
But others see the possibility of another approach. Employers who provide health insurance benefits to most working-age Americans and their families might consider adapting workplace “wellness programs” to reward those who abstain from drinking. alcohol, said Larry Levitt, executive vice president of health policy at KFF, a health policy nonprofit.
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“For an employer, the fact that the surgeon general – who is essentially the arbiter of the nation’s health – is saying this about alcohol consumption gives some credibility to the argument that we should reduce alcohol consumption. “alcohol,” Levitt said.
Why are health insurance companies allowed to charge smokers more?
Under the Affordable Care Act, health insurance plans cannot charge people more based on their medical history or gender. However, the 2010 law allows health insurers to adjust premiums based on age, geography and smoking.
The Obama administration passed a rule allowing health insurance plans to charge up to 50 percent more to anyone who smokes or uses tobacco. No other behaviors, including alcohol consumption, have been targeted by federal law, although insurance plans may offer incentives for healthy behavior.
Some states don’t allow health insurance companies to charge more for smoking. California, Connecticut, the District of Columbia, Massachusetts, New Jersey, New Mexico, New York, Rhode Island, Vermont and Virginia ban tobacco surcharges, according to KFF. Other states limit tobacco surcharges. In Colorado, health insurers cannot charge smokers more than 15% over non-smokers.
Patient groups have expressed concerns that tobacco supplements could prevent people from obtaining affordable coverage. The American Heart Association, for example, does not support tobacco supplements and advocates access to free smoking cessation services.
Corlette said affordable health insurance remains crucial for people looking to overcome addiction.
“If you want someone to stop bad behavior, whether it’s smoking or abusing other substances, the best way to do that is not to make their health insurance unaffordable , but rather to ensure that she can access the preventive care and health services she needs we must combat addiction,” Corlette said.
Could employer wellness programs charge drinkers more for insurance?
Nondiscrimination rules state that employer-sponsored insurance cannot vary costs based on an employee’s health condition. But there is an exception that allows some employees to reduce their insurance premiums, according to Levitt.
Employers who provide health insurance to workers and their families offer wellness programs that help workers quit smoking, lose weight, or change unhealthy behaviors.
The programs aim to reward workers for making healthy lifestyle choices and allow employers to offer financial incentives. worth up to 30% of the cost of health insurance. Although the programs are not supposed to penalize employees who do not participate, these workers could find themselves paying hundreds or thousands more in deductibles or premiums, according to KFF.
“The surgeon general’s report potentially accelerates the debate about the health effects of alcohol consumption,” Levitt said.
Some employers might “see the rationale” for adapting wellness programs to combat alcohol use, said James Gelfand, president and CEO of ERISA’s industry committee, which represents companies that offer employee benefits.
But he added that such programs require nuance. Before raising premiums for smoking, employers must offer people the opportunity to quit smoking through counseling, nicotine replacement gum or patches, or other stop-smoking treatments. Similar options would be necessary for a company looking to encourage its workers to stop drinking.
“You have to give someone an alternative, something they can do,” Gelfand said. “You can’t just say, ‘If you smoke, you pay 50 percent more.'”
Workplace wellness programs often encourage employees to have an annual physical, during which doctors typically ask patients if they drink alcohol. A doctor may recommend follow-up steps or treatment.
If the surgeon general’s warning prompts doctors to be “much more proactive about this, that could lead to insurers becoming more proactive,” Gelfand said.
Are we ready to financially penalize alcohol consumption?
Congress is unlikely to amend the Affordable Care Act to specifically allow insurers to raise rates on alcohol drinkers, Levitt said.
Although Levitt said there is a scientific and cultural consensus that smoking is bad for people, “we’re not there with alcohol.”
“Our approach to smoking has lasted decades, establishing scientific proof that smoking causes cancer and other diseases and establishing widespread efforts to restrict smoking,” he said. “In general, you can no longer smoke in a restaurant, nor in the workplace, nor on public transport. This is obviously not true for drinking.”
Murthy said alcohol directly contributes to 100,000 cancer cases and 20,000 deaths each year in the United States. Meanwhile, smoking and exposure to second-hand smoke lead to more than 480,000 deaths every year, according to the Centers for Disease Control and Prevention.
For millennials, Gen
Many adults are convinced that drinking red wine in moderation is beneficial, Gelfand said.
But surveys show that drinking rates are much lower among Generation Z — young adults who are just entering the workforce. Given these demographic changes, requiring drinkers to pay higher rates “might be easier to implement over time,” Gelfand said.