Senate Health Committee had extensive discussion today about a number of issues related to improving the health and well-being of Californians.
The first revolved around workplace wellness programs. While some large employers have claimed success in promoting prevention and health at the worksite, other employers have used wellness programs ties to health insurance to shift costs to employees and to discriminate against workers with health conditions. For example, if an employer rewards workers for reducing their body mass index, it is inevitably penalizing workers with health conditions that prohibit or make it difficult for them to do the same. Similarly, with an incentive to go to the gym, if an employee lives in an under-resourced community with no gyms, and is unable to participate in the program, they are penalized.
What is even more concerning are programs that base incentives on health status – things like weight and blood pressure and cholesterol which can be mitigated by personal responsibility, but can also largely be determined by genetics and socioeconomic conditions. If workers with poorer health status are penalized by missing out on incentives or are forced to pay higher shares of cost, this had a discriminatory impact based on health status/pre-existing conditions that we have fought to outlaw through the Affordable Care Act. Creating an institutional practice where healthy people pay less, is in effect creating a policy of charging sick people more – when sick people are charged too much, they don’t get health coverage and care and they get sicker. Data has shown that low income people of color suffer the most from these disincentives.
Senator Monning’s bill, SB189 would put into place some important consumer protections (such as basing incentives on participation in programs instead of outcomes and minimizing the increased premiums charged to less healthy workers) that ensure that wellness programs do not unintentionally shift costs to less healthy workers or discriminate based on health status or other factors.
After lengthy debate, the bill passed with the minimum five votes, and Senators Wolk and DeSaulnier not voting.
The other health and wellness related discussion was sparked by another bill by Senator Monning, SB622, which would impose a $0.01/fluid ounce tax on sweetened beverages in order to fund childhood obesity prevention programs. Experts testified about the impact that sweetened beverages and the sharp increase in consumption of “liquid calories” has had on the obesity epidemic and proposed this as one way in which to begin reversing the trend. The bill was widely supported by consumer advocates and health care providers but opposed (not surprisingly) by manufacturers and big business. SB622 passed out of committee on a party line vote.
The committee also took up SB161 (Hernandez) related to Stop Loss Coverage. This bill provides protections to small business employees getting coverage through “self-insured” “stop loss” plans by requiring guaranteed issue, guaranteed renewability, and increasing the “attachment point” or employer liability to $65,000 for the entire firm and $13,000 per covered life. SB161 passed with 7 votes (party-line).
Additionally the committee heard SB126 (Steinberg) extending behavioral services to individuals with autism, and passed the measure with bipartisan support. Other bills included SB780 (Jackson) which requires insurers regulated by the Department of Insurance to notify consumers if provider groups terminate contracts so that they don’t go to non contracted providers and risk expensive bills. SB780 passed on party lines. SB800 (Lara) requires notice to be given to parents of children enrolled in Healthy Families that they may be eligible for coverage in the Exchange in order to facilitate maximum enrollment in the Exchange programs. SB800 got bipartisan support and also moves forward.
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