Healthcare reform could impact wellness programs

NEW YORK (Reuters) - Company wellness programs, designed to coax workers to eat better, smoke less and exercise more, could undergo transformations of their own under healthcare reform proposals under consideration in Congress.

Efforts to overhaul the U.S. healthcare system and expand coverage to millions of uninsured could lead some wellness programs to expand and others to constrict, experts say.

Some two-thirds of large U.S. companies offer some sort of wellness program to lower the health insurance costs, combat absenteeism and boost productivity.

In Congress, lawmakers are grappling to make five separate healthcare bills into versions that can pass the Senate and House of Representatives. They are trying to trim costs, find ways to cover a price tag of $1 trillion or more and gather Republican support for a Democratic-backed government-run public insurance option to cover about 46 million uninsured.

But experts warn the public insurance option could induce some companies to drop employer-based insurance coverage and associated wellness plans.

'USE THE GOVERNMENT PLAN'

"Certainly there are employers now that don't offer healthcare benefits, and if there's a public plan in place, undoubtedly that number will go up," said Lewis Maltby, president of the National Workrights Institute, an advocacy group for human rights in the workplace. "Some employers will certainly say, 'I'm out of here. Use the government plan.'"

Attempts in Congress to thwart that possibility include a proposal to require employers to pay an 8 percent of payroll "fee" if they choose not to provide health benefits to workers.

In all of the bills in Congress, insurers would be required to cover some preventive services, and all of the bills include prevention and wellness incentives.

That could alter what care and coverage are included in wellness programs, such as nutritional counseling or similar programs. "It could affect what employers are willing to do," said John Cawley, a Cornell University professor and expert in health economics.

TAX CREDITS FOR WELLNESS PROGRAMS

One incentive under consideration would give tax credits to companies for wellness programs, said Maya Rockeymoore, head of Washington, D.C.-based Global Policy Solutions consultants.

"They have basically inserted a tax credit for companies that are providing wellness programs, to incentivize companies to provide for wellness programs," she said.

Also, a Senate proposal would set aside funds for the Centers for Disease Control and Prevention to serve as a resource for companies to help them establish and standardize wellness program practices, she said.

However, many people work for smaller companies that do not provide wellness programs, she added.

Wellness programs can be far-reaching or very specific, with programs for nutritional counseling, fitness classes, gym memberships, flu shots, health screenings and the like.

Among workers who do have access to wellness programs, research shows two out of five participate in such programs as disease prevention and one in six in programs for quitting smoking or losing weight.

None of the wellness programs nor congressional bills address the root of such problems as poor diet, long hours or stress, Maltby added.

"We have a corporate culture that almost forces people to be unhealthy," he said. But change would be costly, he said.

"If you let the guy work 9 or 10 hours instead of 10 or 12 so he can get a proper night's sleep and have time to eat dinner, you'll have to hire more people to get the work done and that will cost you real money," he said.