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Alabama to link premium costs to workers' health

  • Story Highlights
  • Alabama obesity levels higher than any other state except Mississippi
  • The new plan pushes state workers to have health screenings, see a doctor
  • Similar plan discounts insurance rates for non-smokers since 2004
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By Matt Sloane
CNN Medical Producer
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MONTGOMERY, Alabama (CNN) -- A new plan that would effectively fine Alabama state employees who don't monitor their health is set to start early next year.

Alabama's plan is not a "fat tax," says William Ashmore, CEO of his state's insurance board.

With obesity levels higher than in any other state except Mississippi, Alabama's insurance board chief William Ashmore and his staff of workplace wellness advocates decided it was time for a change.

"Over 10 percent of the people we screen are at risk for one of the factors we're screening for, and the vast majority had no earthly idea they were at risk," Ashmore said.

But the plan, which encourages state workers to have health screenings and to see a doctor if a problem is found, is angering some employees.

"It's penalizing people for being genetically who they are," says E-K. Daufin, a college professor at Alabama State University. "I have a lovely sexy body mass index of 44 right now," a number that would put Daufin in the group that would have to pay. That is, unless she decided to see a doctor about the issue.

The plans works like this: By 2010, each state employee will be faced with a $50 per month health insurance premium, $25 more than they pay right now. Beginning next year, each employee will be offered a free screening for health factors such as high blood pressure, high blood glucose and body mass index.

If they opt not to take the screening, their premium remains at $50. If screeners find something of concern, the employee will be offered a doctor's visit free of charge, and if they forgo the free visit, their premium remains at $50 as well. Video Fit Nation: Watch more on Alabama's new insurance plan »

However, if an employee undergoes the screening and is found to be healthy or is unhealthy but decides to see a doctor, the premium is discounted to $25.

Similar to a 2004 plan that discounts employees' insurance premiums if they are non-smokers, it is designed to save the state money in the long term.

"It really boils down to managing risk. We know 10 percent of the people are at risk," Ashmore said. "A healthy employee will cost the program less money."

And despite critics from Alabama and across the nation calling it a "fat tax," Ashmore said, the plan is not meant to penalize unhealthy employees but simply to educate them.

"What we want to do is, number one, make the employee aware of any risk factors they may have," Ashmore said, "and then knock down the barriers so that they can go get the services they need."

But the big question many are asking is: Will it work?

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  • MayoClinic.com: Obesity

Emory University physician Dr. David Roberts, who is not connected to the plan, said that if it's done right, it could be a model worth emulating.

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"If they're going to penalize them for [being obese], that's wrong," Roberts said. "If they're motivating them to be involved with a physician and be aware of things, I don't think that's a negative."

If the plan were to be successful, many experts say it could be replicated by other states or by private employers.

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