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Alabama 'Obesity Penalty' Stirs Debate

Plan Calls for State Employees to Pay More for Health Insurance if They Don't Lose Weight
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By Don Fernandez
WebMD Health News
Reviewed by Louise Chang, MD

Aug. 25, 2008 -- Obese Alabama state workers may soon pay a health insurance penalty for their excess pounds.

Beginning in January 2009, state employees will be required to receive medical screenings for several conditions, including body mass index (BMI). Those who are considered obese -- along with exhibiting other negative health factors -- will have a year to get in shape.

The penalty for failure? A $25 increase in their monthly insurance costs.

Although critics view the penalty as a "fat tax," Alabama officials believe the new policies will result in fitter, healthier, and happier employees -- as well as help reduce the state's mounting health care costs.

"Our goal was to make our members aware of those risk factors," Deborah Unger, RN, clinical director for the Alabama State Employees Insurance Board in Montgomery, tells WebMD. "As long as you are aware and are doing something to correct it, there won't be a fee. We either do something to control claims costs or you pay the premium anyway."

Alabama now ranks as the second most obese state in the U.S., according to the CDC -- perhaps a clear sign that change is needed. In addition to BMI, the state will screen three additional criteria: cholesterol, blood pressure, and glucose levels. These four risk factors have consistently resulted in costly treatments for the state.

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