People With Disabilities Who Opt Out of ‘Voluntary’ Wellness Programs Will Pay the Price, and the EEOC’s Okay With That.

Voluntary wellness programs at work can provide benefits to employees, but employers are increasingly adopting “voluntary” wellness programs that unfairly burden workers with disabilities the most of all. Worse, the Equal Employment Opportunity Commission seems to think that’s okay, undermining core antidiscrimination protections it used to defend.

Here’s why.

Imagine a woman living with rheumatoid arthritis and severe depression who, under doctor’s care, has finally returned to work. Her medications — a corticosteroid and an antidepressant — have triggered weight gain. Now imagine this woman facing her employer’s “wellness activities:” She is instructed to fill out a detailed questionnaire about her medical conditions; she is weighed and pronounced overweight; she is told to lose weight. Oh, and the program is voluntary — but if she doesn’t comply, she will have to pay hundreds of dollars more in annual health care premiums. 

This imaginary example is all too real: Persons with disabilities risk discrimination and stigma if their employers gain access to their private medical information. And disabled workers are far more likely to have a condition targeted by wellness programs, such as high blood pressure, high blood glucose, or being overweight. 

Historically, the Americans with Disabilities Act has provided employees with disabilities some protections against overly intrusive and punitive wellness programs. The EEOC has maintained, sensibly, that voluntary medical examinations and inquiries cannot impose penalties on employees who decline to participate. 

Until now.

The EEOC has recently proposed new regulations and guidance language on wellness programs that would allow employers to implement wellness programs that add up to 30 percent of the cost of the employee’s health insurance to an employee’s health care bill. Based on the average annual premium, this translates to an extra cost for disabled employees of about $1,800 per year, either because they don’t want to answer questions that could expose their disability to their employer or because they cannot meet the health goal.

The EEOC describes these programs as “voluntary,” but workers with disabilities are the least likely to be able to afford additional health care premiums. According to the U.S. Census Bureau, median household income for people with disabilities is less than half of household income for people without disabilities: $25,974 compared to $61,103. At the same time, there is little evidence that these programs are effective. 

If the EEOC is going to allow employers to charge workers hundreds more each year, it needs to be sure important privacy and disability protections are in place.

Three safeguards matter the most. First, the EEOC needs to provide guidance language that workers with disabilities have the right to request a reasonable accommodation waiver from a wellness program, so that their medical status can be taken into account in their ability to comply. The guidelines should also protect disabled workers’ privacy, so that their decision to join or not join the wellness program doesn’t broadcast the details of — or even the existence of — their medical condition to their employer. Finally, disabled workers should rest assured that the guidelines protect them from disability-based discrimination in the workplace, such as harassment of employees who cannot comply with “normal” health standards. 

Comments on the proposed regulations are due this Friday, June 19, 2015. Tell the EEOC not to permit employers to subject their disabled workers to a Hobson’s choice: Submit to the prescribed wellness activities, or pay hundreds more each year. The EEOC should instead insure that workers with disabilities can opt out of these programs without penalty. 

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Anonymous

It is truly unjust that ADAs must "hide"from this type of discrimination in the workplace. Hobson's Choice: an ultimatum which leaves NO REAL CHOICE! It seems if you fight to maintain status within society as a disabled person, you face punitive health measures if you're honest with your employer. MUST we encourage "dishonesty"? Is this what our Rights FORCE US TO FACE? Absolutely ludicrous! Nonetheless, the point being, I ENCOURAGE anyone facing this dilemma to KEEP IT PRIVATE. Compliance(s) can be met between you & your Medical Doctor, in PRIVATE. Also, ADAs need not be FORCED to be WELL-CHECKED OR HARASSED. Is it that everyone ASSUMES ALL ADAs are imbeciles and simpletons with absolutely no mental capacity whatsoever?!?! Baaahhhh humbug!!! I, for one, as you can clearly see, am NOT. The only question here is; what measure of a man/woman/child NEEDS that much attention. If THEY REQUIRE said assistance, give it freely for the asking. Meanwhile, leave the rest of us alone. 'nuff said!

Anonymous

I am that woman with Rheumatoid Arthritis, and I can't participate in my company's wellness program because I fear what will happen to me when they figure out that I'm the one on expensive infusion drugs driving up the cost of health insurance. Without those drugs, I wouldn't be walking or working. I'd be more of a burden to the taxpayer b

Anonymous

Fight discrimination with more discrimination? Bad call EEOC. There are so many more awful examples than the one mentioned. Leave the treatment of disabling disorders, and any side effects their treatments may cause, to the treating doctors and therapists. This is a lawsuit waiting to happen.

Bonnie Raymond

Everyone deserves health care, without exception and without giving away private information.
Punishing people for ill health is ineffective and in humane.

Anne Scheetz, MD

1) We need a single-payer health care system under which everyone is automatically enrolled in Medicare from birth to death, with 100% coverage for all necessary health care. Employers should have nothing to do with health care coverage. 2) There is no evidence that "wellness programs" improve health or save money. So there is no excuse for penalizing anyone for not taking part in them. 3) Our health care system is set up to penalize those who have the greatest health care needs--they have much higher out-of-pocket costs even if their premiums are the same. The only cure for this is a single-payer system financed by a progressive tax--pay according to ability, receive according to need. What is good for people with disabilities is good for everyone.

Anonymous

Setting aside medical privacy in the name of not so voluntary "wellness" programs is a bad idea. Medical records are private for a reason, and workers should not have to disclose their medical history and comply with arbitrary and rarely effective programs to avoid paying a penalty. That isn't voluntary, that's extortion on the part of the employer.

Anonymous

I think it depends on the wellness program. My job gives you a discount if you don't have more than 2 risk factors (weight, no, cholesterol, smoking, exercise, etc) or if you do the wellness program if you have 3 or more factors. I don't care what you have, the wellness program is a 45 minute session with a nurse six times a year and (except for quitting smoking) there's no penalty for not meeting your goal if you go to the meetings and there's really no reason not to go. Now if they actually penalized you for not lowering your BP or losing weight it might be different but meeting with a nurse to talk about nutrition won't kill anyone.

Amy Dobek

I am in complete agreement with the ACLU on this. You can call this voluntary all you like, but saying it does not make it so. I cannot afford to look away from the funds that are being proffered, so this becomes coercion, not volunteerism. It's grief-inducing to consider how many people will be discriminated against for profit if we don't stop this now.

Anonymous

I have elected to pay more for my coverage this year after my employer implemented this shaming module because I feel my healthcare is none of their business

Anonymous

I think some people are not getting the ramifications of this post..??

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