The Debate on Employer-Sponsored Wellness Programs

As a provision of the Patient Protection and Affordable Care Act (ACA), employers are encouraged to offer wellness programs to employees and to expand any existing programs to promote healthy behaviors and lifestyles. In a recent survey conducted by the Kaiser Family Foundation, the organization found that the majority of the general public (76%) thinks it is appropriate for employers to offer wellness programs to promote healthy behaviors. However, 62% do not think it is appropriate for employers to require workers to pay more for their health premiums should they not participate in these wellness programs. An even larger majority of individuals (74%) do not think it is appropriate to tie premiums to health goals met by employees (Figure).

The survey respondents then listened to the following arguments for each side in terms of whether or not employers should base premiums on wellness program goals:

       • It is appropriate for employers to charge workers higher premiums for not meeting health goals because workers who are unhealthy drive up healthcare costs and are more likely to be absent from work.

       • It is not appropriate for employers to charge workers higher premiums for not meeting health goals because it is an invasion of workers’ privacy and may unfairly penalize some people who are unable to meet health goals.

Seventy-percent of the total public said the first statement is inappropriate, while 26% said it is
appropriate, and 4% said they do not know or refused to answer the question. Among adults 18 to 64 years of age with insurance provided through their employer, 75% said the first statement is inappropriate, while 21% said it is appropriate, and 2% said they do not know or refused to answer the question.

Almost half of the survey respondents (48%) said their employer offers some form of a wellness program, with 27% who said their employer offers a participatory program, 16% said their employer offers both a participatory and outcome-based program, and 2% said their employer offers just an outcome-based program. Among the respondents who said their employer offers either a participatory or outcome-based program, more than 6 in 10 (63%) said they participate in the wellness program.
Reported participation rates were higher among women than men (73% vs 54%, respectively).

The researchers also asked about the favorability of the ACA at the time, and most (45%) had an un-
favorable view of the law versus a favorable one (39%). Most Democrats had a favorable view of the law (66%), while most Republicans had an unfavorable view (74%). Independents were somewhat split, with 31% favoring the law and 54% not favoring the law.

This tracking poll was conducted between June 12 and June 18, 2014, among a nationally representative random digit-dial telephone sample of 1202 adults ≥18 years of age living in the United States, including Alaska and Hawaii. Computer-assisted telephone interviews were conducted by either landline (n=601) or mobile phone (n=601). The survey was carried out in English and Spanish by Princeton Data Source under the direction of Princeton Survey Research Associates International. Of the 1202 interviews conducted, 476 were with individuals 18 to 64 years of age with employer-sponsored insurance, 471 were military households, and 731 were nonmilitary households.—Kerri Fitzgerald