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Keeping “Wellness” from Turning into Discrimination

| May 8, 2013

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Today, I had the honor of testifying before the U.S. Equal Employment Opportunity Commission (EEOC) on a topic of critical importance to our nation’s workers: employer wellness programs. These programs can offer women and families meaningful avenues for improving and maintaining their health. And, as part of the Affordable Care Act, employers will soon have new incentives to establish them. But they can also open doors to discrimination.

Employer wellness programs are aimed at promoting healthier lifestyles and improving health outcomes by encouraging health-related activities like signing up for gym memberships, taking health education classes, getting health risk assessments and more. They come in two basic forms: “participatory” wellness programs, which are available to employees regardless of a person’s health; and “health-contingent” wellness programs, which are tied to certain health benchmarks or targets. It’s the latter that cause concern.

There is no one-size-fits-all approach to individual health, wellness and life circumstances, and employer wellness programs must reflect that. That’s why they should be voluntary, carefully designed, and not tied to health indicators. Groups like women, older adults and racial minorities experience significant health disparities. Tying wellness program penalties to their health situations can cause them disproportionate harm and, as I argued today, violate nondiscrimination laws.

Health-contingent wellness programs that increase health care costs for certain workers aren’t about wellness; they are about shifting costs to working people, especially those with health problems. And there’s no scientific evidence that shows they do anything to improve health outcomes. That’s why the National Partnership is recommending that the EEOC:

  1. Issue specific and thorough guidance to employers to inform them of best practices in designing and implementing wellness programs, as well as potential legal implications;
  2. Engage in outreach and education to employers to help ensure compliance with nondiscrimination laws;
  3. Enforce the law by challenging employer wellness programs that are discriminatory; and
  4. Work with other agencies — including the Departments of Treasury, Labor, Justice and Health and Human Services, and the Office of Personnel Management — to provide the assistance employers need to prevent discrimination in the implementation and regulation of employer wellness programs.

At the National Partnership, we know that access to affordable, quality health care is essential for women and families. We also know the importance of ensuring people can work free from discrimination. Today, I made clear that, with proper oversight, wellness programs can do both: They can help women and families achieve meaningful improvements in their health, without running afoul of our nation’s civil rights laws. We will do all we can to ensure this happens.

You can read my full written testimony here.

About the Author

Judith L. Lichtman

Judith L. Lichtman

Judith L. Lichtman has been a guiding and influential force in the women's movement for more than 40 years. She stepped down as president of the National Partnership for Women & Families in 2004, and is presently senior advisor at the National Partnership. Her commitment, vision, and talent as an attorney and advocate have made a profound difference for women and families across the United States.

Lichtman often says: "I went to law school because being a lawyer gave me a license for activism." After receiving her law degree from the University of Wisconsin in 1965, Lichtman worked for the Department of Health, Education and Welfare, Jackson State College, the Urban Coalition, the U.S. Commission on Civil Rights, and as legal advisor to the Commonwealth of Puerto Rico. In 1974, Lichtman became the executive director and first paid staff person for the Women's Legal Defense Fund (WLDF), which became the National Partnership for Women & Families in February 1998.

Under Lichtman's leadership, the National Partnership has been at the forefront of every major piece of civil rights legislation related to women and families for more than 40 years. Founded as a small volunteer group, the National Partnership has grown into a national organization with thousands of members and has become one of the country's most influential strategic forces, shaping national policy through its advocacy, lobbying, litigation, and public education. Lichtman's vision and the National Partnership's strength and direct leadership have resulted in the passage of some of the most important legal protections for American women and families, including the Pregnancy Discrimination Act of 1978 and the Family and Medical Leave Act (FMLA) of 1993. In 1996, the National Partnership helped shape key provisions of the Health Insurance Portability and Accountability Act (HIPAA) that make it easier for women and their families to get and keep health coverage. More recently, Lichtman has led efforts to promote patient protections and to bring paid family and medical leave to California.

Lichtman has been recognized by civic and legal organizations, business and labor leaders, and others for her strategic abilities, political savvy, effectiveness in creating powerful and diverse coalitions, and her tireless commitment to building a truly just society. President Clinton called Lichtman "a remarkable national treasure," and Washingtonian magazine has identified her as one of Washington, DC's most powerful women and Washingtonian of the Year in 1986. The Sara Lee Corporation awarded her the 1989 Frontrunner Award in the area of Humanities. That same year, the Women's Bar Association named her Woman Lawyer of the Year. In 2000, Lichtman received the Leadership Conference on Civil Rights Hubert H. Humphrey Award for her contributions to the advancement of human and civil rights.

Says Lichtman, "For over 40 years, I've tried to make this world a better place for women and families. We've come a long way, but our work is far from done. My daughters, and all our children, deserve a future where every school and workplace is truly free of discrimination, and where all families have the support they need to succeed at home and on the job. I know from experience – if we can imagine it, we can make it happen."

Lichtman lives in Washington, D.C., with her husband Elliott. They have two married daughters and four grandchildren.