WASHINGTON (CN) – Three health care bills sponsored by Republicans – none of which would replace President Obama’s maligned health care law – nonetheless inspired impassioned debate Wednesday at the House.
The three-hour hearing before the Education and the Workforce Committee elicited what have become familiar partisan refrains. While Republicans blast the Patient Protection and Affordable Care Act as a disastrous failed law on the verge of collapse, Democrats say the law has helped insure millions of Americans who lacked coverage before.
Republicans say Americans need more choice in their plans and doctors, but Democrats say the details on a replacement plan are lacking and that Americans with pre-existing conditions might die if Republicans repeal Obamacare.
The bills debated Wednesday run the gamut from aiming to preserve employee-wellness programs to protecting self-insurance options and improving health care choices for employees of small businesses.
“We believe patients, not Washington bureaucrats, should be in charge of their health care decisions,” committee chairwoman Rep. Virginia Foxx said to open the hearing.
“We believe employers should have more choices, not fewer, to provide their workers with access to affordable coverage,” added Foxx, a North Carolina Republican. “We believe small businesses should be empowered to negotiate for the best coverage at the best possible price for their employees.”
The legislation faced stiff opposition at the hearing from Lydia Mitts, of the advocacy group Families USA, who said all three bills will hit the most vulnerable workers the hardest.
“All of these bills would promote the scaling back of employee health plan benefits and shift a greater share of costs to workers,” Lydia Mitts said. “These changes would harm access to affordable, comprehensive coverage, particularly for older and sicker workers.”
Mitts zeroed in on the Preserving Employee Wellness Programs Act, expressing concern it would become a “backdoor” to the proliferation of wellness programs in corporate America.
Wellness programs offer employees health-risk assessments and biometric screenings to help them make better lifestyle choices, and can include programs to help workers stop smoking, lose weight or manage diabetes.
The intended result for employers is higher productivity and worker morale, and lower health care costs, though the latter remains difficult to quantify.
Many wellness programs use incentives for participation, however, ranging from cash rewards and free gym memberships to reduced premiums and lower deductibles.
Workers who fail to meet certain program requirements may face penalties, Mitts said.
If employees refuse to undergo what Mitts called “invasive health screenings,” for example, employers can charge workers and their families higher costs for health coverage.
Mitts said employers right now can tack on a 30 percent surcharge to employee-only insurance premiums if employees do not meet wellness program requirements, which amounted to about $2,000 in 2016.
Under the proposed bill, employers could add 30 percent to the cost of family coverage, which would spike the surcharge to about $5,500, Mitts said.
“The bottom line is that efforts to support employee health need to focus on providing evidence-based services, not shifting health care costs to workers,” she said.
Members of Congress were painted a brighter picture of wellness programs by Tehsaid Allison Klausner of the American Benefits Council, which represents mostly Fortune 500 companies.
Klausner said workplace wellness programs has reduced absenteeism in the workplace, while boosting productivity and morale.
“Wellness programs have been enormously successful,” she said.
The Patient Protection and Affordable Care Act increased employer flexibility to design wellness programs, but Klausner said layered and inconsistent regulations pose a risk.
Because the Affordable Care Act codified some aspects of the Health Insurance Portability and Accountability Act as they relate to wellness programs, Klausner said wellness programs that comply with it could in turn violate the Americans With Disabilities Act.
The Preserving Employee Wellness Programs Act could mitigate that by clarifying that Obamacare- and HIPAA-compliant wellness programs do not violate the Americans With Disabilities Act or the Genetic Information Nondiscrimination Act simply by offering rewards.
That would be “a step toward consistent federal policy,” Klausner said.
Adding another regulatory layer that complicates things, however, Klausner noted that the Equal Employment Opportunity Commission issued regulations in 2015 that are inconsistent with HIPAA.
“The unnecessary burdens imposed on employers by multiple incongruent regulatory structures stifle adoption and innovation of wellness programs,” she said. “We are concerned the future of workplace wellness programs is at risk.”