The More You Weigh, the More You Pay
In an innovative new program, the state of Alabama has given its close to 40,000 employees until 2010 to lose weight or they will have to begin paying $25 per month for health insurance that would otherwise be free. Alabama would be the first state to penalize its obese workers financially; similar programs in other states just reward employees who practice healthy behaviors. Alabama already has a similar program in place for smokers—it charges them $24 per month for health insurance if they do not quit. In this post, we’ll explain more about the program and how it works.
How It Works
As of January 2010, if Alabama state workers don’t get a free health screening, they will have to begin paying the $25/month charge. If the health screening identifies serious problems with cholesterol, blood pressure, obesity, or glucose, the employees will have the chance to see a doctor for a year at no cost, join a wellness program, or take actions of their own to improve their health. If the employees with problems show progress at a follow-up screening, they will not be assessed the $25/month fee. If they don’t show improvement, though, they will have to begin paying the charge.
Who Pays the “Fat Fee”
The state will apply the obesity charge to anyone with a BMI (body mass index) of 35 or higher who is not making progress on their follow-up health screening. To give an example, a person who is 5′6” and weighs 220 pounds would have a BMI of 35.5. Typically, a BMI of 30 is considered the obesity threshold. The state has not yet decided how much progress a person would have to make to avoid the charge upon follow-up screening, nor have they estimated how many people would have to pay the charge since everyone can avoid it by losing weight. However, that all Alabama state employees would work to accomplish this goal is unlikely - the CDC reports that 30.3% of Alabamans are obese. This percentage makes Alabama the second-most obese state in the U.S. behind Mississippi.
The Critics
Alabama’s program is not without its critics. Opponents point to recent studies that indicate that about half of overweight people and one-third of obese people actually have normal cholesterol and blood pressure levels. By contrast, 25% of people considered to be within a normal weight range are plagued with many of the ills associated with obesity. Some critics are concerned that overweight employees will get unhelpful, simplistic advice to walk more and avoid fried foods. This may not be enough to combat a chronic, pernicious disease like obesity, and, as a result, employees of size will be stuck paying an extra $300 per year for a disease some feel the state failed to cover in an appropriate manner in the first place.