Obama vs. 'Bama

August 22, 11:52 AMDenver Health ExaminerDonna Feldman

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Pay more for medical insurance? (wordpress.com)

Here's news sure to raise the ire of Barack Obama and his policy makers:  The state of Alabama is planning to charge overweight state employees $25 per month for medical insurance.  Up until now, insurance coverage has been free.  But apparently someone at the State Employees' Insurance Board has figured out that obese employees are running up medical costs, and it's time to do something about it.  

Alabama, ranked second in the nation in obesity, has already charged smoking employees a monthly fee, and no one objected to that.  The proposed obesity fee doesn't kick in until January 2010.  At that time, employees can have free health screenings.  If risk factors for the common, and expensive, lifestyle diseases are found, those employees are given a year to make changes.  After a year, if they haven't improved risk factors - weight loss has the biggest impact - they will be charged the monthly fee.  Any employees who refuse to have the free screenings in 2010 will automatically be charged the fee.

So this is risk factor screening enforcement by default.  However, the proposed parameters are pretty generous.  The obesity charge doesn't kick in unless a person's BMI is a whopping 35.  The CDC defines obesity as starting at a BMI of 30, when incidence of weight-related diseases rises sharply.

Meanwhile, Barack Obama makes it clear that he is completely opposed to charging anyone more for medical insurance based on disease risk, even people whose risk is entirely due to personal lifestyle choices, rather than genetics.  So, since the Alabama rule isn't due to kick in until 2010, all those extremely obese state employees have nothing to worry about if Obama is elected.  The rule will be history before it takes effect, meaning the taxpayers of Alabama will have to pick up the costs for high risk state employees, and no one will have to make any unpleasant lifestyle changes.