One Good Thing About Obamacare
Six months ago, the President signed his healthcare legislation into law. The conventional wisdom at the time was that most – if not all – of the reforms would be implemented.
President Clinton said at the time: “The minute the president signs the healthcare reform bill, approval will go up, because Americans are inherently optimistic.” Medicare, Medicaid, S-CHIP – all these gigantic healthcare programs offered good precedent.
For the record, I was on side. Writing here on March 24, I sounded practically Clintonian: “Let’s be clear, for all the hot talk about repeal and sweeping Republican victories in the fall, much of this legislation is here to stay. Sunday was a game changer.”
Six months have now passed. Newspapers and blogs are filled with commentary. Regardless of your view of the law, this much we can all agree on: the debate over Obamacare is far from over. Even groups that, it seemed, were just yesterday waxing enthusiasm, are now palpably cooler. With implementation phased in over the next decade, with so many decisions on regulations and interpretations to be made in the coming years, 2010 marks simply the end of the beginning, not the beginning of the end.
I’ve spilled much ink over the past 19 months first criticizing the administration’s approach, and then its final legislation. Today, though, I wish to praise one aspect of the law: the ability of employers to discount premiums for certain employees who participate in wellness programs or achieve certain health goals.
Previously, employers could give up to 20% off premiums for employees based on enrollment in wellness programs and the like; with Obamacare, that will jump to 30% (and 50% if a healthcare plan is approved by the Secretary of Health and Human Services).
Proposed rules in early Affordable Care Act drafts nearly outlawed any premium variation. Fortunately, not only was the variation preserved but it was tweaked with the legislation now giving greater flexibility to employers. Senators John Ensign (R-NV) and Thomas Carper (D-DE) get credit here by offering an amendment that made this change possible. Thank goodness for the bipartisan work of these two senators.
At a time when we increasingly understand the connection between health and the healthcare costs of bad health, this reform is an important step.
If anything, the change seems modest. Why only discounts for healthy behaviors and not penalties for bad ones? Shouldn’t a smoker pay more than his triathlon-participating co-worker two cubicles over? If a man with high cholesterol doesn’t take his medications, why should his colleagues subsidize his reckless choice through their premiums and compensation?
Still, at 6 months, let’s recognize that, with the Ensign-Carper amendment, Washington took a healthy step in the right direction.