By Jackie Jones

A few extra pounds soon could cost you way more than just good health.

As the House and Senate work to reconcile their versions of national health care legislation, patient advocates say a provision intended to encourage healthier habits would create a loophole for the insurance industry to make Americans pay higher premiums.

If a provision of the Senate version of the bill prevails, employers would be granted more leeway in determining the rules of workplace wellness programs. Currently, employers may give rewards not exceeding 20 percent of the cost of health insurance coverage. The Senate billS Patient Protection and Affordable Care Act (H. R. 3590) would increase that amount to 50 percent.

On the surface, it sounds as though employers are being encouraged to push wellness programs to help workers get healthy and save everyone money. But a number of patient advocacy groups contend that the bill could actually penalize workers who suffer from chronic conditions and those who fall short of program goals, even if only by a little.

“Such exorbitant penalties undermine a fundamental goal of healthcare reform – the creation of a system in which no one can be charged more based on their health status,” said a letter signed by representatives of groups including the American Heart Association, AARP, the American Diabetes Association, and the National Disability Rights Network.

According to a brief from the National Partnership for Women and Families, “Research has demonstrated that women are more likely than men to suffer from a chronic condition, meaning that women could pay disproportionately more for health insurance under these programs than their male colleagues. Such disparities are even more acute for low-income women and women of color.”

African Americans are disproportionately represented among those who have a variety of illnesses, including hypertension, heart disease, type 2 diabetes and related illnesses and complications, including blindness, limb amputations and kidney disease. For many black Americans, hypertension and diabetes are often genetic, but can be exacerbated by diet, lack of exercise and being overweight.

Ted Okon, executive director of the Community Oncology Alliance (COA), which represents cancer care providers across the U.S., has said that smoking, a lack of exercise and poor eating habits have exposed African Americans to a slew of health problems, including an increased risk of cancer.

“If we do a better job in two areas, nutrition, diet – an increasing percentage of the population is overweight – and smoking, we would make a dent,” said Okon, who is an advocate of wellness programs generally – especially diet and smoking cessation plans – and encourages African Americans to take greater charge of their health.

The Democrats, in a summary of the benefits of the bill (http://democrats.senate.gov) hailed the bill, saying it would:

• Eliminate co-pays and deductibles for recommended preventive care
• Provide individuals with the information they need to make healthy decisions
• Invest in a national prevention and public health strategy

Supporters say the legislation does provide protection against health discrimination, but some patient advocates are not buying. They contend the bill provides no parameters for what constitutes a wellness program, leaving it up to employers to determine the benefits and their limits.

“This is not workplace wellness, this is cost-shifting,” Sue Nelson, vice president of the American Heart Association, told reporters in a recent interview. She said costs would likely move from healthy employees to sick employees, and from employers to employees.

Meanwhile, patient advocates are working with congressional leaders to come up with language in the final bill they all can live with.

“While the bill is not perfect, we look forward to working with the House and the Senate to make the bill better as they move to conference,” George J. Huntley, chairman of the board of the American Diabetes Association said in a statement. “This was an important step in the process.”

Jackie Jones is a freelance writer as well as a career and fitness coach for those who want to get their lives in shape.