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White House May Push Health Plans to Create Wellness Programs

Joe Cantlupe, for HealthLeaders Media, February 3, 2010

First Lady Michelle Obama is taking on a bloated nation and health insurers may one day have to help.

Health plans are now trying voluntarily with wellness, fitness, and disease management programs, but those offerings could become mandatory as the nation searches for ways to reduce health costs. Will insurer programs help pare the pounds?

While the First Lady gets ready to launch a major anti-obesity initiative, the beer ads, and fast-food ads will be a part of the Super Bowl commercial ritual. While watching, the calories will pile on probably a lot more than tacklers taking on Peyton Manning.

America is a contradictory place.

Michelle Obama announced her crusade against obesity, particularly child obesity, last week in a news conference with Health and Human Services Secretary Kathleen Sebelius. Later next week, she is expected to finalize her specific plans and announce those proposals.

Execs who run health plans aren't exactly sure what she'll release, but nobody seems to be worried about any "requirements." Indeed, the Obama Administration's war against fat has trimmed down, reflective of the overall healthcare package, which is being sliced and diced in the Senate and House conference rooms.

When Obama and Sebelius announced their plans to combat obesity, they emphasized the importance of wellness plans, being initiated across the country by employers, various health advocacy groups, and insurance companies.

Indeed, in some respects the administration is putting its money where its mouth is: a few days after the announcement, the White House's proposed 2011 budget was released, which includes plans to reduce childhood obesity rates by budgeting $1 billion to improve children's access to healthy meals, and include $10 million in a federal employee workplace initiative to implement prototype wellness programs.

No mention was made about putting any "requirements" on insurance plans.

That wasn't the case when Sebelius spoke in July 2009 before the Centers for Disease Control and Prevention at a "Weight of the Nation" conference. At that time, Sebelius noted, "The President and First Lady have made investing in prevention and wellness one of their top priorities."

"It's why we're going to require health insurance plans to cover preventative services like the kind of counseling and care that can help people lose weight or keep the weight off in the first place," she said.

These days, as the Obama Administration rather quietly tries to salvage the healthcare reform package, nobody mentions requiring health insurance plans to cover preventative programs.

"We always have difficulties with well-intentioned but unfunded mandates," says Don Bradley, chief medical officer and senior vice president at Blue Cross Blue Shield of North Carolina. "But we are doing (wellness and other programs). The thing is we don't know what works in combating obesity. It's important to launch these projects carefully and analyze what works and what doesn't." The problem isn't simply a matter of burning calories, Bradley says. "It's the behavioral part and the environment."

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