Our company warned us about this today, employees & their families next year will be paying different rates based on smoking, weight, and other factors.
It is probably long overdue, bad drivers pay more for auto insurance and home owners pay more if they live in forest fire areas, but traditionally, by pooling the employees, everyone paid the same rate.
Fair to do?
Thomas Sowell: There are no solutions, just trade-offs.
My understanding is that is barred under the ObamaCares.
Health insurance issuers would be required to maintain a single statewide risk pool for each of their individual and small employer markets, unless a state chooses to merge the individual and small group pools into one pool. Premiums and annual rate changes would be based on the health risk of the entire pool. This provision prevents insurers from using separate insurance pools within markets to get around the market reforms and to charge people with greater health problems higher premiums by increasing their premiums at higher rates than other, healthier risk pools.
Edited to add:
It turns out there are exceptions to the single risk pool that allow for discrimination for certain conditions including tobacco use, age, etc.
Health insurance issuers in the individual and small group markets would only be allowed to vary premiums based on age (within a 3:1 ratio for adults), tobacco use (within a 1.5:1 ratio and subject to wellness program requirements in the small group market), family size, and geography. All other factors – such as pre-existing conditions, health status, claims history, duration of coverage, gender, occupation, and small employer size and industry – would no longer be able to be used by insurance companies to increase the premiums for those seeking insurance.
Under the law, states can choose to enact stronger consumer protections than these minimum standards. In addition, starting in 2017, states have the option of allowing large employers to purchase coverage through the Exchanges. For states that choose this option, these rating rules also would apply to all large group health insurance coverage. These proposed rules standardize how health insurance issuers can price products, bringing a new level of transparency and fairness to premium pricing.
Right now, the legal limit is 20% for weight and smoking, but this can go up to 30% in 2014.
I can imagine there will be big legal fights over what counts as a pre-existing condition, or genetically based.
There is a precedent for differing rates on life insurance, smokers pay more, diabetics pay more, people whose parents die young pay more.
Thomas Sowell: There are no solutions, just trade-offs.
My husband's company aggressively implemented an optional healthy living plan (offered discounts on gym memberships, incentives to quit smoking, formed bike racing teams and now ride in the Tour De Cure every year - last year were the 2nd largest fundraising company even though they only had 20 people riding vs the largest fundraiser who had 150 and got a big tent with personal masseuse provided by race organizers, pay for a subscription for everyone to a Safety magazine, etc), hired a wellness coordinator several years ago, and have seen health care costs significantly drop with the employees who've volunteered to participate. Companies can save themselves a lot of money if they start being proactive rather than reactive, and they get more productivity out of healthy employees, and a happier, more stable workforce because people don't leave for greener grass elsewhere.
"Now, more than ever, the illusions of division threaten our very existence. We all know the truth: more connects us than separates us. But in times of crisis the wise build bridges, while the foolish build barriers. We must find a way to look after one another as if we were one single tribe.” -King T'Challa, Black Panther
The truth is incontrovertible. Malice may attack it. ignorance may deride it, but in the end, there it is. ~Winston Churchill
(CNSNews.com) – A pre-existing condition health insurance program established by Obamacare is already straining its own budget and, to control costs, the administration’s Health and Human Services Department (HHS) has stopped enrolling any new people in the program, according to an audit by the General Accountability Office (GAO).
In addition, to further control spending, HHS has directed the program to shift more of the costs onto the current enrollees, thus raising the out-of-pocket health care expenses for the people with pre-existing conditions.
“Finally, due to growing concerns about the rate of PCIP [Pre-existing Condition Insurance Program] spending, in February 2013, CCIIO [under HHS] suspended PCIP enrollment to ensure the appropriated funding would be sufficient to cover claims for current enrollees through the end of the program,” states the GAO report, Patient Protection and Affordable Care Act: Enrollment and Spending in the Early Retiree Reinsurance and Pre-existing Condition Insurance Plan Programs.