GOP Health Bill Could Let Companies Pressure Workers To Give Genetic Test Results

WASHINGTON ― Imagine your employer wants you to submit to genetic testing as part of a “workplace wellness” program. The testing is completely voluntary, your employer says. If you’re concerned about your privacy, no one can force you to take part.

There’s just one catch: Declining to provide genetic testing results will cost you thousands of dollars each year in higher health insurance premiums. In that case, how voluntary would the program feel?

Such a futuristic-seeming scenario may not be far off if a proposal moving through the GOP-controlled House becomes law. A Republican bill that made it out of committee last week would enable companies to withhold financial benefits from employees who don’t take part in genetic testing as part of a workplace wellness program.

The committee measure passed, 22-17, on a party-line vote with all Democrats opposed. There is no equivalent bill yet in the Republican-controlled Senate, but such a proposal could become part of the health care overhaul now consuming Capitol Hill as Republicans try to repeal and “replace” the Affordable Care Act.

If it finds its way into health care reform, the measure would provide employers with a carve-out from nondiscrimination and privacy laws when it comes to workplace wellness programs. Under current law, genetic testing can be part of a wellness program, but an employer can’t make it a condition of benefits.

The GOP measure would allow that. It doesn’t mean your employer could force you to undergo such testing and share the results ― but your employer could essentially withhold money if you don’t. 

Dozens of health and privacy advocacy groups have come out against the bill.

The risk of disclosure can extend beyond the worker’s health. In one case cited by the Labor Department, a job candidate was rejected after disclosing screening results that showed he carried a single genetic mutation for Gaucher’s disease, which meant only that he could pass the mutation on to a son. 

A spokeswoman for Rep. Virginia Foxx (R-N.C.), chairwoman of the House Committee on Education and the Workforce, said the bill would not change the fact that employees could choose whether or not to participate in such a program.

“Those who are opposed to the bill are spreading false information in a desperate attempt to deny employees the choice to participate in a voluntary program that can reduce health insurance costs and encourage healthy lifestyle choices,” she said. “We believe working families should be empowered with that choice, and so did the Obama administration. It is another sad reminder of just how extreme the Democrat Party and their liberal allies are becoming.”

As The Huffington Post’s Jonathan Cohn has reported, workplace wellness programs have become a popular way for companies to try to save money on employee health care costs. In a typical program, a worker might provide her employer with a basic health screening ― cholesterol level, body-mass index ― as well as a rundown of her habits ― how much she exercises, whether she smokes, etc. In some cases, an employee might even agree to losing a certain amount of weight or hitting a blood pressure target.

The idea behind those programs is to nudge employees toward a healthier lifestyle and prevent them from getting sick; that, in turn, would keep employers’ insurance costs down. In return for taking part, the employee gets anything from a small gift card to thousands of dollars in health care savings a year. According to a Kaiser Family Foundation survey, 83 percent of large employers offered wellness programs last year, and 42 percent of them came with financial incentives. Most programs had a maximum reward of a few hundred bucks.  

Setting aside whether or not these programs actually work, the money at stake raises the question of how voluntary they are. So far, the law has come clearly down on the side of businesses. Under President Barack Obama, the Equal Employment Opportunity Commission set rules allowing companies to dangle incentives worth 30 percent of a worker’s insurance premium, deeming such arrangements voluntary.

The implications of the bill were first reported by Stat reporter Sharon Begley. Jennifer Mathis, director of policy at the Bazelon Center for Mental Health Law in Washington, D.C., told Begley that the bill would “completely take away the protections of existing laws” ― namely, the genetic information protections in the Americans With Disabilities Act and the Genetic Information Nondiscrimination Act.

The language of the new bill states that workplace wellness programs “shall be considered to be in compliance” with the relevant provisions of those laws.

“While the information returned to employers would not include workers’ names,” Begley noted, “it’s not difficult, especially in a small company, to match a genetic profile with the individual.” Such arrangements would also put test results in the hands of the third-party firms that operate the wellness programs.

House Republicans said the change would give employers “the legal certainty they need” to implement workplace wellness programs. They have dubbed the bill the “Preserving Employee Wellness Programs Act.”

Rep. Bobby Scott of Virginia, the committee’s ranking Democrat, told HuffPost in a statement that the Republican bill would “coerce” workers into forking over sensitive medical and genetic information to their employers, “undermining key workplace civil rights.”

“This is yet another policy proposal that will disproportionately harm sicker and older people, as well as those who have disabilities that may not be readily noticeable,” Scott said. “Information disclosed in these programs could also result in discrimination in employment.”

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