Obamacare Backer: Wellness Rule Leads to 'Culture of Deceit'

Friday, 02 May 2014 12:28 PM

By John Gizzi

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A little-noticed part of Obamacare is leading to a "culture of deceit" in the workplace with employees blatantly lying about their efforts to meet health standards, according to  outcomes-measurement consultant Al Lewis, a Boston Democrat.

Lewis, who supports Obamacare, told Newsmax that the "Safeway Amendment" — which contains incentives and requirements to encourage workers to stay healthy — could lead to what he called "made-up evidence" to support the program.

Named for the supermarket chain that has long had health and exercise rules for its employees, Safeway's wellness program allegedly saved huge amounts of money for the company, but Lewis noted the program "in reality did not exist at the time the company's healthcare spending declined."

"But now that the Affordable Care Act is law and the Safeway Amendment is on the books, there is a culture of deceit settling in at the workplace to meet its standards," said Lewis, who has voted twice for Barack Obama for president.

Under the Affordable Care Act, employers are allowed to offer wellness incentives up to 30 percent of the total cost of an employee's health insurance, and up to 50 percent for incentives related to not smoking. In 2013, large employers with wellness programs offered an average incentive of $594 per year.

"Even at that rate," wrote veteran wellness program manager Bob Merberg, "you might wonder how seven people could collect $310,960."

Merberg, author of "The Health Seeker's Handbook," wrote in his blog recently how in Missouri, six Kansas City employees and one from Jackson County "were indicted for defrauding the wellness incentive program provided, through their employer, by their health plan.

"The program awarded gift cards and debit cards to employees who self-reported, on the plan's website, completion of wellness activities. According to many initial reports, these employees collected $310,960 by falsely claiming they had completed triathlons, marathons, and other strenuous events."

Noting that "sometimes the employees are required to do nothing more than claim they completed an activity — as in the Kansas City case," Merberg said that "even employers less inclined to place blind faith in their employees' self-reported fitness achievements are likely to take their word in a manner only slightly more formal — for example, having them submit an attestation saying they don't smoke in exchange for a discounted health-insurance premium."

One woman Lewis put Newsmax in touch with — and who requested anonymity, dubbing herself "Anxious and Waiting" — told of her employer changing from a "voluntary, incentive-based wellness program to a mandatory, incentive-based participatory program."

She freely admitted that "initially, I was able to find loopholes in the program that I could exploit to technically comply, thus qualifying for the $1,200 'incentive,' and yet avoid turning over my personal information. The second year, the loopholes had been closed and I was forced to pay for the privilege of maintaining my privacy.

"The third year, covered spouses and domestic partners were 'invited' to participate, but it was not mandatory for them. My husband declined to participate and, once again, I opted to pay the $1,200 penalty rather than comply with the employee mandate."

Now, after the Obamacare implementation, the rules have changed again, she said.

"This year, the wellness program is mandatory for employees and their covered spouses/domestic partners. So, if neither my husband nor I comply with the three program requirements — complete a [health reimbursement account] and biometric screening, including a mouth swab for tobacco, and certify that we will or have received a preventive exam in 2013 or 2014 — we will be forced to pay a $4,200 penalty — $2,400 for me and $1,800 for my husband.

"That's 25 percent of the value of my health insurance benefit, and according to the Affordable Care Act, there is no limit to how much I can be penalized for not complying," she said. "I could be forced to pay the full value of my health insurance benefit, which is more than $16,000."

She said "this threat is nothing short of financial extortion. How is any employee supposed to stand against this kind of financial pressure? I do not understand how they can justify what they are doing."

As much as he supports Obamacare and insists "I'll pay higher taxes for it," Lewis concedes that anecdotal stories such as this make it clear that "giving companies the chance to control employees' behavior is leading to a culture of deceit on the part of the workforce."

"The wellness provision, or Safeway Amendment, needs to be surgically removed from the Affordable Care Act," Lewis said. "And if Democrats are smart, they'll vote with Republicans to remove it."

John Gizzi is chief political columnist and White House correspondent for Newsmax.

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