September 24, 2009 [Washington, DC] – Today Lung Cancer Alliance joined patient, employee and health care occupation advocate groups to express concern about two pending amendments to the America’s Healthy Future Act of 2009.  The amendments, authored by Senators Carper (D-DE) and Ensign (R-AZ), would expand authority provided under the Health Insurance Portability and Accountability Act of 1996 (HIPAA) that allow for limited premium variation based on health status for employees of wellness programs.  The amendments would allow wellness program employers to vary premiums depending on the personal health status of the employee, in an effort to encourage healthier lifestyles and lower health care costs.  While we appreciate the amendments’ intent to encourage these healthy behaviors the coalition is concerned that allowing employers to vary premiums by as much as 50 percent of the total cost of employee coverage could lead to discriminatory practices and make health coverage unaffordable for those who need it most.

The letter to Chairman Baucus raised three specific concerns regarding the amendments:

First, the affordability of employer based insurance plans could be severely impacted for the employees that do not meet certain standards related to health fitness.  Under current law, such standards can be used to vary an individual’s premium by no more than 20% (or an average variation of $2,675 a year).  The proposed amendments would increase that limit to 50%, representing a variation of as much as $6,688 in annual premiums.

Second, there is no peer reviewed research evidence documenting that such major increases in premiums would encourage employees to live healthier lives, and as a result, reduce cost.  However, there is evidence that patients are less able to manage chronic conditions when their deductibles or co-payments are too high. 

Third, privacy issues are of considerable concern to employees who prefer to share personal information only with their physicians.  Concern exists that such an invasive policy may violate certain privacy measures, as well as, unfairly burden employees who fail to release certain medical information or are unwilling to compete a health assessment, with higher premiums. 

Lung Cancer Alliance will continue to monitor the status of these amendments.  Please visit LCA’s Legislative Priorities Page for more information.