The Affordable Care Act (ACA), also known as ObamaCare, is most known for the expansion of access to health insurance, as well as improvements in what health insurance covers. However, the ACA also does a great deal to incentivize wellness.
In the past, American health care was more of a “sick care” system. No one thought of using health care until they were ill or something was physically wrong. As a result, the health care system bore the weight of expensive treatments that could have been avoided. According to HealthyPeople.gov, over 80% of both adults and adolescents do not receive the recommended amount of physical activity, and 1 in 3 adults is obese. Obesity-related illnesses include heart disease, stroke, and type 2 diabetes, which place a staggering burden on the US medical system. Heart disease, cancer, and diabetes now cause 70% of U.S. deaths and account for 75% of health care expenditures.
The wellness incentives in ObamaCare recognize that healthy choices are made outside of the doctor’s office or hospital.
Free Preventive Services
One of the first steps to taking charge of personal wellness is making sure to get regular screenings and preventive services. The ACA requires that most health insurance plans provide these services without cost sharing, such as a copayment or deductible. This makes them easy for Americans to obtain. Medicare also covers a new annual wellness exam as well as preventive services without cost sharing. Some of the key preventive services include:
- Blood pressure screening for all adults
- Cholesterol screening for all adults
- Type 2 diabetes screening for adults with high blood pressure
- Diet counseling for adults at risk for chronic disease
- Immunization vaccines for hepatitis A and B, flu, measles, and other diseases
- Sexually Transmitted Infection (STI) prevention counseling
- Preventive services for children including hearing, vision, oral health, and vaccinations
So far, about 71 million Americans have received coverage for at least one free preventive service through private insurance, and an additional 34 million Americans have received such coverage through Medicare. As health insurance enrollment continues to increase, even more Americans will have the chance to use these services to prevent illness.
The ACA and Workplace Wellness
For employers, healthy employees are more reliable and productive. They help the company save on the costs of overtime or additional hiring to replace missing staff. In addition, a healthier workforce reduces the cost of providing health insurance to employees. The ACA makes it easier for businesses to reward employees who participate in wellness programs, often by reducing their insurance premiums. Some programs available to employers include:
- Health education and coaching
- Weight management programs
- Health fairs
- Medical screenings
- On-site fitness programs
One company taking advantage of wellness programs is Citibank. The Citibank Health Management Program reported a savings of $4.50 for every dollar spent on employee wellness programs. Studies show that an increasing number of employers are offering employee wellness programs, including 77% of large manufacturers and 29% of small businesses. In addition, long-term incentives, such as a system of earning points toward a catalog of prizes, have been shown to have a positive influence on employee involvement in health programs over time.
The ACA protects employees by making sure they are not discriminated against for existing or chronic illness. Every employee must have options to earn the awards.
The ACA and Healthy Communities
ObamaCare includes the creation of the Prevention and Public Health fund to support local efforts to advance wellness in the community. This includes supporting heart health education and promotion, weight loss challenges, smoking cessation programs, and more.
Public health is an important issue, as 70% of U.S. deaths are related to preventable diseases such as obesity, diabetes, high blood pressure, heart disease, and cancer. 75% of our health care dollars are spent treating these diseases. In comparison, only 3% of our health care money goes toward prevention. The ACA aimed to change that with the Prevention and Public Health Fund, which will be $615.5 million in 2013 and will grow to $2 billion per year by 2022.
These funds are being used in a variety of ways, including community prevention of specific diseases, to spread awareness of clinical preventive services and benefits, to bolster public health infrastructure at the state and local levels, and to increase research and data tracking regarding public health. One example of a funded program is the Community Transformation Grant in Iowa. This initiative expands access to blood pressure and tobacco use screenings at dental practices throughout the state, increases the number of referrals to Iowa’s tobacco Quitline service and targets health interventions for the areas with the highest stroke mortality rates.
The ACA and Healthy Eating
Obesity in the United States has reached epidemic proportions. More than one-third of U.S. adults are obese. The annual medical costs of those who are obese are $1,429 higher than those of normal weight. Minorities and the poor are the most likely to be affected. In 2012, no U.S. state had an obesity level below 20%.
The ACA targets obesity by making healthy eating choices easier, especially for Americans on the go. Major chain restaurants and vending machines will soon be required to prominently display calorie information on their menus so that diners can make informed choices. Many familiar restaurants are already incorporating calorie counts next to food items.
Wellness care is an important way to take care of your health. Don’t wait until you are sick to seek out community programs that encourage wellness. By taking wellness steps today, you can avoid the pain, struggle, and financial impact that chronic disease brings. Look for community programs in your area, and encourage your friends and family to think about taking care of their health, not just their illnesses.