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NC State Health Plan Wellness Provisions Unlikely to Lower Health Costs

For those who hope that the NC State Health Plan new punitive [1] “wellness” provisions (random cheek swab workplace salvia tests for smoking and random workplace height and weight measurement) will save money for NC, an analysis [2] recently done by the Congressional Budget Office in response to prevention and wellness provisions in national reform proposals is illuminating:

In an effort to improve health and reduce medical costs, many employers — particularly large employers—offer their workers wellness programs designed to encourage healthy living. Those programs include nutrition and weight loss programs, discounts for gym membership, smoking cessation programs, and other personal health coaching. Although some case studies suggest that certain wellness programs reduce subsequent medical care, little systematic evidence exists.

In other words, there isn’t much evidence that wellness programs save much money. This shouldn’t be a surprise – two actuarial [3] analyses of the State Health Plan’s wellness provisions during the debate over the bill in the General Assembly came to the same conclusion: any actual health savings from these programs are ephemeral at best.

If savings do emerge to the state from the wellness provisions they will come from one place – simply shifting substantially more health care costs to state employees. The penalty for smoking or being overweight in the NC Health Plan will not be paying an extra fee every month as many states have instituted. Rather employees and their families (regardless of family member smoking status) will be involuntarily placed in the 70/30 health plan option which requires thousands of dollars more a year of cost sharing than the standard state health plan.

Encouraging state employees to stop smoking and exercise more is a worthy goal. Penalizing state employees with thousands of dollars in bills is not the way to do it.