Red Stop Button

Stop Having That Chronic Disease!

Perhaps it had to happen. CEOs are mad at the EEOC for challenging features of wellness programs that could have the effect of discriminating against people with a chronic disease. So they have persuaded a small group of legislators to introduce a bill in the Senate and the House to prevent EEOC from acting on such complaints.

Simply put, the proposed law would rule out discrimination complaints about wellness programs based on the Americans with Disabilities Act (ADA) or the Genetic Information Nondiscrimination Act (GINA). If it’s part of a wellness program, then it’s not discrimination. This proposed law says so. All problems should be so easily solved.

Three suits by the EEOC stirred up all this angst. In one case, a lighting company fired a woman who opted out of their wellness program. In another case, a plastics company canceled an employee’s medical insurance when the employee did not agree to medical testing for the company’s wellness program. The most contentious case involved a Honeywell program that would penalize low-wage employees up to $4,000 for not participating in their wellness program.

The core issue in each of these cases is that wellness programs are required by the ADA and GINA to be voluntary. For people with a chronic disease like obesity, some of these wellness programs represent nothing but another burden on top of the burden of trying to manage their chronic disease. But when people face firing or unbearable penalties for opting out, these programs aren’t voluntary.

In practice, wellness programs are evolving into two forms. About seven percent of U.S. employers have comprehensive, carefully implemented wellness programs. The underlying ethic is to create a culture of health where people spend most of their waking hours.

But other employers are discovering that wellness programs with hefty penalties can cut healthcare expenses. They don’t need to improve health outcomes. They simply shift healthcare costs onto employees who opt out or can’t meet arbitrary outcome goals — like a BMI under 30.

If the goal is health, coercive penalties have no place in a wellness program. If the goal is cost shifting, employers should fess up and do it more honestly across the board.

Penalizing people for having a chronic disease is simply wrong.

Click here for the text of the bill, click here for more about it, and click here and here for more about the issue.

Red Stop Button, photograph © Ben K. Adams / flickr

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