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Government Goes to War (for Wellness)

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The federal government is trying to emulate private health insurers and put more emphasis on keeping healthy people healthy.

U.S. Surgeon General Regina Benjamin has released a National Prevention Council Action Plan that will guide federal government efforts to address matters such as obesity, tobacco use, and chronic disease.

The plan should complement existing federal, state and private-sector wellness programs, officials say.

A provision in the Patient Protection and Affordable Care Act of 2010 (PPACA) called for 17 federal departments and agencies to set up a National Prevention Council. The council is supposed to change the national health care focus to prevention and wellness, away from the current focus on responding to the health problems people already have, officials say.

Some large health insurers have expressed support for PPACA preventive services provisions, including one that requires them to cover some basic preventive services without imposing out-of-pocket costs on the patient.

House Republicans have questioned federal agencies’ spending on some PPACA public communications provisions.

Private employers and insurers are becoming increasingly aggressive about efforts to get consumers to participate in private-sector wellness and condition management programs and suffer consequences if they fail to meet program standards.

One provision in the new federal prevention plan calls for all departments and agencies on the council to work to expand access to healthy, affordable foods.

The prevention council notes in the plan that the council’s strategy encourages government agencies to work with a wide variety of non-governmental partners, including insurers.

Federal agencies cite implementation of the new PPACA Summaries of Benefits and Coverage (SBC) provisions and the PPACA preventive benefits coverage provisions as examples of steps they’ve already taken to empower Americans to live healthier lives.

The SBCs are supposed to be clear, concise, standardized descriptions of health insurance plans and policies.

The preventive services provisions require non-grandfathered health plans to provide coverage for basic preventive services, such as checkups, without imposing out-of-pocket charges on the patients.

The SBC and prevetive services provisions “will allow people to make more informed decisions when choosing an insurance plan and coordinating care with their providers,” officials say.


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