There is still buzz around whether people can be charged more in health premiums for being fat under Obamacare. As far as I can tell, and discussed in my November 1, 2012 posting, “Beyond ‘If I’m re-elected’: Pre-Existing Conditions and the ACA,” it appears the answer is, “No.” As I cited in that post:
“Of interest here is section 2701-Fair health insurance premiums and (a)-prohibiting discriminatory premium rates.
Under the ACA, the ONLY TWO JUSTIFIABLE REASONS UNDER THIS SECTION FOR RAISING PREMIUM RATES ARE AGE (Which allows 3 to 1 variation) and TOBACCO USE which allows for 1.5 to 1 variation. No one else can legally be charged more for insurance premiums based on a pre-existing condition.”
Adult smokers can be charged more than young or old narcotics addicts, than people who engage in extreme sports, than those who ride motorcycles, than those who drink themselves silly every night. That’s the current law. Apparently choosing smokers and the old for higher premiums is NOT discriminatory? Oh well, that's Obamaworld.
What is the impact of the AMA classifying obesity as a disease this summer? Allegedly it will help get insurers to pay for treatments for the disease. I see trouble coming for the obese, because there's nothing insurers hate worse than paying.
The ACA currently discriminates against smokers and the old, one a traditionally protected class (age) under current laws, and one that it is argued here should be a protected class unless additional premiums can be extracted from all others who engage in ANY unhealthy ‘elective’ behavior from taking drugs, drinking alcohol, to living in a city with high crime or pollution. Currently, although “Addiction” is viewed as a disease, and is not eligible for higher premiums charged, an addiction to smoking is singled out by the ACA for higher premiums.
It’s really about money for insurance companies and that’s why, fat people watch out. As we’ve already seen, even if we didn’t know it, just because the ACA is law doesn’t mean it can’t be modified and tweaked. I anticipate that within a few years’ experience of the obesity as disease label prompted by physicians angling for better insurance coverage for any number of obesity "treatments," we’ll see insurers lobby to get premium increases for the obese as they start to pay for those treatments.
The flaw in the argument of covering or not covering elective behaviors, and charging more or not charging more for cherry-picked behaviors is that eventually insurers will go after everyone in order to pursue their goal, maximum dollars for minimum coverage.
So, rather than picking on the alcoholics, the drug addicts, the obese as examples of other people who should have to pay more in premiums much like the old and smoking, it is argued here that if the law of Obama concludes that discriminatory premiums should be prohibited, there should not be exceptions for the old and smokers.
In the meantime, it looks like the obese are safe, for now. Young people will be paying more, old people will be paying more, and smokers will be paying more.
