Expansion of Employee Wellness Programs under PPACA Creates Additional Barriers to Healthcare Insurance for Individuals with Disabilities

By Cheng, Amy B. | Journal of Law and Health, Summer 2016 | Go to article overview

Expansion of Employee Wellness Programs under PPACA Creates Additional Barriers to Healthcare Insurance for Individuals with Disabilities


Cheng, Amy B., Journal of Law and Health


I. INTRODUCTION                                                     192 II. MEANINGFUL ACCESS AFTER THE PPACA                               196        A. Alexander v. Choate                                       197        B. Meaningful Access under the ADA                           199        C. Meaningful Access and Premiums under PPACA                203 III. WELLNESS PROGRAMS SHIFTS COSTS TO THE EMPLOYEE                 204        A. PPACA Antidiscrimination Provision                        206        B. PPACA Continues Cycle of Discrimination                   208        C. Seff v. Broward County                                    209 IV. REASONABLE ACCOMMODATION UNDER THE ADA AND ITS IMPACT ON WELLNESS PROGRAMS                                                211        A. Statutory Language Requirement for Alternative Considerations in Wellness Programs                                 212        B. Impact of Reasonable Accommodation to Wellness Programs for Individuals With Disabilities                          213 V. CONCLUSION                                                       215        A. Redefining What It Means to be Voluntary                  215        B. Through the Eyes of an Egalitarian: Re-interpreting Reasonable Accommodation under the ADA                              217        C. Additional Barriers in Healthcare                         218 

I. INTRODUCTION

There are many barriers to healthcare for the general population that has been documented throughout the years, with one particularly affected group being individuals with disabilities. (1) One identified healthcare barrier for individuals with disabilities is the inability to gain access to the healthcare system through health insurance. (2) While many attempts have been made to resolve this issue, serious problems have yet to be resolved. (3) The Patient Protection Affordable Care Act ("PPACA") attempted to solve the issue by expanding Health Insurance Portability and Accountability Act of 1996's ("HIPAA") current regulations on employee wellness programs. The relevant regulations govern employee wellness programs to allow employers to offer their employees greater incentives for meeting employer-defined health targets. (4) This expansion has an adverse effect because it disadvantages groups like individuals with disabilities by penalizing them through higher premiums or cost sharing when they are unable to meet wellness targets. (5)

The cost of healthcare in the United States ("U.S.") continues to rise every day, and is currently the highest per capita in the world. (6) In 2012, the U.S. spent an estimated $2.8 trillion on healthcare. (7) The continued rise of medical care and health insurance costs mainly impact the uninsured and the underinsured. (8) Such increases deprive over fifty million people of the proper healthcare they need, including many individuals with disabilities. (9) Many individuals with disabilities are either uninsured, underinsured, or both. (10) As a result, individuals with disabilities who are underinsured are burdened with high cost-sharing obligations, which prevent them from obtaining a variety of healthcare needs. (11) As a way to curb healthcare costs, employers who offer benefits to their employees now offer employee wellness programs. (12) Wellness programs, known as disease-management programs, can take many different forms and offer a wide range of benefits from informational to preventative care. (13)

Health law means "laws that govern access to health services and health insurance coverage, as well as those intended to restore or promote health and wellness with a focus on 1) public health insurance, laws governing private health insurance, and 3) public health initiatives and regulation." (14) The PPACA is a health law that regulates the health industry. PPACA expands the employee wellness program, a program that promotes health and disease prevention at work. (15) This new rule allows employers to reasonably design and make available to every employee a health wellness program that reward or punish their employees monetarily through their health insurance payments plans as a way to encourage employees to meet a specific health standard. …

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Expansion of Employee Wellness Programs under PPACA Creates Additional Barriers to Healthcare Insurance for Individuals with Disabilities
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