Fox News' Steve Doocy falsely claimed the Affordable Care Act (ACA) makes wellness programs “illegal” when, in fact, the law expands them.
On the December 18 edition of Fox & Friends, co-host Steve Doocy interviewed attorney Eric Miller, who had received notice from his insurer that he was being transferred to a new health insurance policy. Miller's old plan provided incentives for healthy behavior, such as mandatory doctor visits and exercise. After Miller complained that his new plan would not offer the same benefits, Doocy claimed “so you got a discount under your old plan because you were healthy. But under Obamacare, that's going to be illegal, right?”:
The ACA not only does not make wellness programs illegal, it provides added incentives and grants to expand such programs. A Department of Labor fact sheet pointed out that the law “creates new incentives and builds on existing wellness program policies”:
The Affordable Care Act creates new incentives and builds on existing wellness program policies to promote employer wellness programs and encourage opportunities to support healthier workplaces. The Departments of Health and Human Services (HHS), Labor and the Treasury are jointly releasing proposed rules on wellness programs to reflect the changes to existing wellness provisions made by the Affordable Care Act and to encourage appropriately designed, consumer-protective wellness programs in group health coverage. These proposed rules would be effective for plan years starting on or after January 1, 2014.
The proposed rules continue to support workplace wellness programs, including “participatory wellness programs” which generally are available without regard to an individual's health status. These include, for example, programs that reimburse for the cost of membership in a fitness center; that provide a reward to employees for attending a monthly, no-cost health education seminar; or that provides a reward to employees who complete a health risk assessment without requiring them to take further action.
The ACA also raises an existing limit on the financial incentive employees can receive for participating in wellness programs from 20 percent of the health plan's cost to 30 percent:
Prior to the passage of the ACA, workplace wellness programs had been required to comply with a number of state and federal requirements, including one that allowed employers to offer a financial incentive to employees for participating in a wellness program of up to 20 percent of the total annual cost (employer and employee) of the health plan. Gym membership discounts, smoking cessation and weight loss programs have been the most common offerings.
In 2014, that incentive will be increased to 30 percent for workplace programs. In addition, there will be further clarification of what type of intervention qualifies as a wellness program and the initiation of 10 pilot programs in the individual marketplace.