Should employer-based health plans now jack up rates on the unvaccinated?

[Algernon Moncrieff]

We have an FDA approved vaccine. COVID cases that result in hospitalizations are enormously expensive and can have long-term impacts.

On the other hand - freedom of choice.

"Yes" in this poll has an implied caveat for those medically unable to be vaccinated to be exempt from rate penalties.

38 votes, 1 pass | Time left: Time expired
	Yes
	29 (76%)
	No
	9 (24%)
	1 DU member did not wish to select any of the options provided.
Show usernames Disclaimer: This is an Internet poll

[JT45242]

1. I agree but...

Someone pointed out that vaccination status could be considered a 'pre-existing condition' so they would be protected by the ACA.

I think ther eis a difference between willfully not getting vaccinated and a pre-existing condition but better legal minds might need to chime in

[Ms. Toad]

9. It isn't that it is a pre-existing condition -

It is that the ACA does not (as a general rule) permit premium discrimination based on any health condition (pre-existing or not). The only exception is smoking.

[ShazzieB]

36. Being unvaccinated is not a health condition.

IANAL, but somehow I feel certain of this. I can't explain it (maybe because I've been up all night, and my brain is fuzzy, ha), but I just don't see how voluntarily declining to take a vaccine can possibly fit into that category.

[Ms. Toad]

40. It doesn't matter what you believe -

It is what the law says.

The law was expressly intended to prevent insurance companies from making access to health care contingent on making good health choices. "Health conditions" isn't a general guiding principle. Prices must be the same across the board, unless there is an express exception.The sole two exceptions which are health-related are smoking (a personal decision to engage in unhealthy behavor), and age (which inherently brings higher costs). The only other variables are not health related at all: geographic location, family v. individual, and level of coverage.

[Hoyt]

2. Agree. But that sets precedent for charging people more for weight, alcohol, not exercising, etc.

[frazzled]

3. Yes, as long as it doesn't lead to a slippery slope

Raising rates on the unvaccinated seems wholly justifiable in the context of the pandemic (and the illogical, often politically motivated obstinacy of the vaccine haters). But it could be a slippery slope to what is known as "risk selection"--that is, raising rates on people with illness, even if through no fault of their own. We went through this before with the ACA wars, and thank the lord that denying insurance or charging higher rates for pre-existing conditions was banned. But laws are not forever things, and I fear that insurers might use this as a precedent to start all kinds of cost-saving tactics or to lobby for changes. If we allow rate hikes for being unvaccinated, and they can successfully argue that being unvaccinated is a pre-existing condition, it could open a floodgate. With the current Supreme Court, I wouldn't trust the outcome.

So if you are a breast cancer survivor with risk of future metastasis, or a diabetic who didn't get the proper medication or treatment, or etc. etc., could this become a slippery slope back into the old days?

So while I'd love to say "absolutely," I have some reservations about the implications for the future, and for the rest of us.

[Ocelot II]

4. Employer-based health plans governed by the ACA can impose surcharges

for specific things, like smoking. The ACA would have to be amended to include not getting vaccinated. Also, if a surcharge is imposed for smoking the employer is required to offer its employees a smoker cessation program, so the employer would have to offer an anti-vax cessation program. Seems to me it would be easier just to impose a vaccination mandate: Get the jab or don't work here.

[Ms. Toad]

8. Agreed.

People have very short memories as to health care.

I guess that means they have the luxury of not having anyone with chronic health conditions in their family. I certainly can't forget the pre-ACA impossibility of getting access to health care for my daughter.

Vaccine requirement is a far better route.

[ShazzieB]

37. LOLOL!

"anti-vax cessation program"

Omg, your analogy is flawless, but that particular combination of words is absolutely slaying me! It sounds like some sort of re-education training course, or maybe deprogramming would be a better word. Yes, please, let's deprogram all these antivax idiots, right here and now!

Thanks for the early morning belly laughs!

P.S. When I was trying to type "deprogram," autocorrect kept changing it to "deplorable," until I finally beat the damned thing into submission. How freaking funny is THAT?

[Klaralven]

5. Health insurance should have a "points" system like auto insurance

They could assign points for incurring avoidable medical expenses.

[luv2fly]

6. No it's a slippery and steep slope (n/t)

[fescuerescue]

25. It's a slope that banned from existing

Banned by SEC. 2704. PROHIBITION OF PREEXISTING CONDITION EXCLUSIONS OR OTHER DISCRIMINATION BASED ON HEALTH STATUS.

[Ms. Toad]

7. Under the PPACA, employers cannot do that.

I am astounded how many people forget one of the main premises of the ACA: Non-discrimination based on health conditions.

It applies to both individual and employer plans - and the only health-based distinction for which a higher premium can be charged is smoking.

[Algernon Moncrieff]

10. Is the choice not to receive a vaccine a condition?

I think that is a question coming to a court near you.

[Ms. Toad]

12. In general, there are ony 5 reasons for disparate charges

smoking, age, geography, family v individual, and level of coverage (bronze, etc.)

Refusing to vaccinate is not one of them.

[groundloop]

27. refusing a vaccination is in the same boat as smoking....

Like smoking, it's a personal choice to put your own well being at risk.

Surcharge the shit out of anti-vaxxers.

[Ms. Toad]

28. The category is smoking, not "personal choice to put your own well being at risk"

You'd have to change the law.

Under the health care law, insurance companies can account for only 5 things when setting premiums.

Age: Premiums can be up to 3 times higher for older people than for younger ones.

Location: Where you live has a big effect on your premiums. Differences in competition, state and local rules, and cost of living account for this.

Tobacco use: Insurers can charge tobacco users up to 50% more than those who don’t use tobacco.

Individual vs. family enrollment: Insurers can charge more for a plan that also covers a spouse and/or dependents.

Plan category: There are five plan categories – Bronze, Silver, Gold, Platinum, and Catastrophic. The categories are based on how you and the plan share costs. Bronze plans usually have lower monthly premiums and higher out-of-pocket costs when you get care. Platinum plans usually have the highest premiums and lowest out-of-pocket costs.

https://www.healthcare.gov/how-plans-set-your-premiums/

Which one of the five factors allow insurance companies to charge more for vaccination status?

[fescuerescue]

15. Won't get far in court

The ACA law is pretty darn clear.

[sarisataka]

11. Why, after battling for years

To get insurance to cover virtually all medical conditions do we wantvto start reversing those gains?

There are many poor choices people make that can lead to expensive care later. Should people have to report how much they drink so they can be charged for potential future cirrhosis?

[fescuerescue]

14. Exactly. This is exactly one of the changes to ACA that the Republicans tried to pass

And was defeated multiple times in Congress by Dems.

I'm seeing a lot of people unknowingly join the Republicans on this.

[demmiblue]

18. +1

[leftstreet]

26. +1

[fescuerescue]

13. They can't. That is illegal

Health based rates are banned under the Affordable Care Act.

[Algernon Moncrieff]

16. I hear what you are saying. Here is my thought.

The pandemic must end. Economically this is not sustainable. While I'll stop well short of saying "broad bipartisan support" it seems plausible that a coalition to amend the law could emerge.

My hope is that it doesn't come to that. There do seem to be flickers of hope that this latest Delta surge may finally be changing minds about getting vaccinated in Trump country.

[fescuerescue]

24. Any law can be changed

Obamacare can certainly be amended.

The right would welcome such a coalition. They have been trying to raise rates on the sick for years. They would WELCOME our help.

[Algernon Moncrieff]

38. Being unvaccinated is not a preexisting condition

It's preventing a future condition from taking place. That is completely different than raising rates on someone that often I'll and had no way of preventing- like cancer or type 1 diabetes.

[fescuerescue]

42. "pre-existing condition" is just a colloquial shorthand

that we use for a lengthy complicated section of law.

The bottom line is that it's illegal to base rates on health status.

Except for smoking.

It's the #1 one thing that Obamacare established. Now some people want to throw it away because the people getting sick vote in a way that we don't like.



If you want the precise legal definition:

It's all here: https://www.congress.gov/111/plaws/publ148/PLAW-111publ148.pdf

Search for "‘‘Sec. 2704" or "discrimination based on health status."

[LiberalFighter]

21. Do you have anything to back it up?

[fescuerescue]

23. Yes. It's all here.

This was covered from head to toe and back again during the Obamcare debates.

The entire reason for the mandate require everyone to buy insurance was to insure that healthy people joined at the same rates as sick people because the entire premise of the law was to BAN insurance companies from pricing out people who are sick.

The law itself is over 20,000 pages. It's all here: https://www.congress.gov/111/plaws/publ148/PLAW-111publ148.pdf

Search for "‘‘Sec. 2704" or "discrimination based on health status."

I"m not trying to be snarky here at all. Honest. It's just that this is a such a basic tenet of the law, something hard fought for and won, that I'm a little shocked that this is a surprise to anyone on this site.

we literally cheered when it passed, and now many people here are lamenting that we can't "stick it to the sick people". (Mostly because they don't vote the way we want them to)

But let's come at it from a practical side. There are 900 health insurance companies in the US. Not one. Not a single one has raised rates on the unvaxxes, or even proposed it during this 18 month long pandemic.

Don't you think that at least one greedy bastard in that 900 would have found a way to jack up rates on the uninsured if they could?

[Coventina]

17. I agree with the idea in principle, but what would follow would be horrible.

They would claim the right to jack up rates for EVERYTHING.

Are you overweight? Higher premium.

Do you drink alcohol? Higher premium.

Do you eat enough vegetables and fruits? No? Higher premium.

Do you take a multivitamin everyday? No? Higher premium.

It would never end.

[LiberalFighter]

20. They already do for some.

[LiberalFighter]

19. Vaccinated should not pay for the stupidity of others.

[Hekate]

22. Cigarette smokers already pay an insurance surcharge for their future likelihood of disease...

Tobacco-related diseases are very well-known — predictable and preventable. Insurance companies are hedging against that future — not denying coverage, not denying care, just charging more.

Uncle Joe keeps offering lollipops and hugs — the carrot. Here comes the stick from Big Business in all its forms.

[ripcord]

29. Unvaccinated people will cost insurance companies more

They have to charge more, that's capitalism right?

[Algernon Moncrieff]

39. It's not like asking people to give up fritos and cupcakes for life

COVID has killed roughly 200x the number of Americans that died on 9-11, and left thousands more with long-term debilitating symptoms. Its crippled the economy. So yes, if you won't get a simple shot taking 5 seconds to administer that costs nothing and has a low occurrence of side effects, then yes - I think you should pay for that choice.

[UTUSN]

30. Mine does for smokers

[denbot]

31. No but conditional on giving them a choice between the ACA, or financial ruin.

Then their heads will actually explode thinking that socialized medicine was the goal of the former guy's plandemic.. Problem solved.

[GulfCoast66]

32. Not an issue at my company.

By October if not vaccinated your employment will be terminated.

[Elessar Zappa]

33. Good company you work for.

I’m hoping more follow suit.

[RANDYWILDMAN]

34. Voted yes, my job is making everybody anyways...

if TFG had sent everybody the message of the masks and Vax we would had a lot less death and he would have won again, which would have made for a dark cloud on america for 4 more years at least.

[Sapient Donkey]

41. I'm generally against any moves to make healthcare less accessible

While there may be situations where it's warranted, I don't have the imagination to come up with those situations. I am assuming the idea of raising the price is to make it hurt to not be vaccinated to the point that they get vaccinated to alleviate the financial suffering. And in cases where they still refuse, the increased premiums would help off-set some of the costs, and in theory prevent the insurance companies from increasing premiums across the board. I suppose we could make the increases a tax rather than just more profit for the insurance company. Those tax funds could then be used to help cover COVID treatment costs.

For that to have any real affect the increases would have to be pretty substantial. Given the mindset of the average anti-vaxxer, how many will cancel their healthcare insurance rather than pay that fee? From what I've seen, most people don't think multiple steps ahead. In their mind they are winning. They are not only saving money, but they are taking stand on their misguided beliefs. So, now we end up with a bunch of uninsured people who are more likely to get COVID. I can also imagine anti-vaxx pseudo "insurance" scam plans similar to those ministry healthcare plans popping up. This won't just affect adults making these decisions either. Those adults have children who will be uninsured. These kids will get hit double time from not having insurance and also most likely not being vaccinated. I don't like seeing children suffer because of their parent's poor decisions. All of these uninsured people will end up costing us more money without the benefit of increasing vaccination rates. At least that is how it plays out in my head.

Even if we limit the increases to an amount that it doesn't push people to the point of dropping their plans, I'm certain a large number would do it in principle. The amount of funds collected would be minimal to the point of having limited effect on paying for the extra costs, and would likely have minimal effect on vaccination rates.

I would much rather use the carrot method. Carrots are not only delicious, but also a great source of beta-carotene that helps improve our foresight. People like money. Give refundable tax credits to people who are vaccinated. Sure that will cost money, but compare that the potential savings it would have if we can snuff out COVID for the most part. Actually, I would probably make it something more immediate than just tax credits to counter people who have a problem thinking more abstractly. Maybe send out checks immediately. People seeing their neighbors get a $500 check (or whatever) for getting the vaccination would be a huge motivator. Some people might even have a change of heart on their "deeply held" convictions about vaccines.

I apologize for the incoherent stream of thoughts above.

[ecstatic]

43. I don't think they're allowed to based on ACA law

Isn't there a clause stating that minimum coverage plans can't cost more than 9% (?) of an employee's income?