Alabama officials are warning state employees to shape up or pay more for health insurance.
On Friday, the State Employees' Insurance Board announced a new plan beginning next year in which state employees will be required to receive medication screenings for several conditions, including body mass index. Those considered obese or who have high blood pressure, high cholesterol or high glucose will have to pay $25 a month more in health insurance beginning in January 2011, if they don't take steps to address their health problems.
The new rule will affect more than 37,000 people employed by the state. Alabama is the first state to issue a so-called fat tax. The state already charges smokers a $24 per month surcharge (which will increase to $25 next month).
Alabama has the second highest obesity rate in the country, according to the U.S. Centers for Disease Control and Prevention. Just over 30% of the population is obese, ranking just behind Mississippi. Still, a fat tax?
Alabama state officials say they will offer programs, such as Weight Watchers and YMCA discounts, to help the employees get in shape and avoid the penalty. But health experts aren't so sure a punitive approach is the best way to lower healthcare costs. The American College of Occupational and Environmental Medicine has published a list of tactics employers can use to help fight obesity. The list is made up entirely of positive incentives; nothing suggesting fines or penalties.
Jeffrey Levi, executive director of Trust for America's Health and a health policy expert at George Washington University, told WebMD that the Alabama requirements could be interpreted as a genetic penalty for those who are predisposed to weight or cholesterol problems. "We need to recognize the complexity of these things," he says.
-- Shari Roan
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