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Note: Healthy Compromise: Reconciling Wellness Program Financial Incentives with Health Reform

By Heather Baird. Full text here.

Soaring health care expenditures coupled with plummeting insurance coverage suggest something is seriously wrong with the American health care system. One way that the ACA proposes to control health care costs is through support for employee wellness program initiatives. Wellness programs with financial incentives based upon health status risk create financial barriers to health care by using health insurance to single out and discriminate against individuals with poor health statuses. This Note suggests that financially incentivized wellness programs are ill-suited to achieve the dual aim of improving health and saving money because the legal and policy tensions these programs create threaten to undermine the ACA’s goal of promoting health and preventing disease. This Note examines wellness programs under HIPAA and the ACA, and explains the evolution of wellness programs in American insurance schemes. It concludes with some ideas about how the ACA’s wellness provisions can be improved to better balance the statutory objectives of promoting healthy living without unduly burdening the unhealthy.