California Lawmakers Take a Stab at Legislating Healthy Habits

Last week, an Assembly committee approved a bill that would require companies bidding on California state contracts to provide wellness benefits for employees.

It’s not a big part of anybody’s health reform package, and the odds aren’t good that AB 2360 by Lloyd Levine (D-Van Nuys) will become law, but the attempt represents a significant shift in thinking about health care and how it can be legislated.

“I truly believe we’d be a lot better off in California if we try to figure out a way to encourage people to get and stay healthy,” Levine said.

“So much of Western medicine is geared to reacting when something goes wrong that we don’t pay a lot of attention to staying away from trouble. This bill is another attempt to encourage good healthy habits,” Levine said.

Legislating Healthy Habits on the Rise

A generation ago, attempts to legislate wellness and healthy habits were unheard of. They’re still rare now, but less so.

Amy Winterfeld, health policy analyst for the National Conference of State Legislatures, said wellness-related bills are on the rise in several states.

“There has been a noticeable increase in the number of bills promoting wellness programs in state legislatures,” Winterfeld said.

She said bills have taken different approaches to encourage wellness programs, including insurance premium discounts or rebates for participation in wellness programs, discounts in group premium rates and tax credits.

“In some states, wellness initiatives have been included as an element of health reform efforts and as part of state employee health insurance benefits,” Winterfeld said. Some states have appointed a state-level surgeon general to oversee wellness initiatives, Winterfeld added.

One other state — Michigan — is considering legislation similar to Levine’s, giving preference in state contracting to companies with employee wellness programs.

Levine’s bill would apply to companies with 10 or more employees bidding on contracts worth more than $1 million. Businesses could comply in a variety ways — by subsidizing memberships for fitness clubs, installing fitness facilities, sponsoring employee athletic teams or providing employees with health information.

The bill would apply to state contracts awarded by the Department of General Services, including consulting contracts, contracts for supplies and materials, as well as IT and telecommunications contracts. The Legislature has not analyzed the legislation’s potential fiscal impact, but the requirement could apply to hundreds of state contracts.

The bill is sponsored by the International Health Racquet & Sportsclub Association, which represents more than 9,000 health and fitness facilities, and more than 700 equipment suppliers in 71 countries.

Bill Approved on Party-Line Vote

The vote to approve Levine’s bill in the Business and Professions Committee was 7-3. Democrats voted yes, Republicans voted no.

“Anything we can do to encourage healthy lifestyles is a good idea, I think, especially with regard to onsite fitness programs for employees,” said Mike Eng (D-Monterey Park), chair of the Business and Professions Committee.

“If we can make it easier for people to have access to exercise, I think it will pay off,” Eng said. “As a personal example, in my first year in the Legislature I gained 14 pounds, and my doctor told me I was a prime candidate for diabetes. He told me when we work in a sedentary environment and maybe only walk a few steps from one desk to another all day, we’re setting ourselves up for problems like diabetes. And diabetes can lead to blindness, loss of limbs, all kinds of problems which can become a huge burden to our overburdened health care systems.”

Assembly member Bill Emmerson (R-Redlands), an orthodontist in Southern California and vice chair of the committee, was one of three Republican committee members to vote against the bill.

“As a health care provider, I think it’s important to maintain a healthy lifestyle; however, I don’t think it’s the role of the Legislature to mandate that businesses provide this benefit to their employees, especially when the state government is not required to provide this same service,” Emmerson said.

Bill Maze (R-Visalia) also voted against the bill.

“Just because it’s a ‘nice’ idea to have a wellness plan, it is not necessarily good public policy to mandate it,” Maze said.

The bill now moves to the Assembly Appropriations Committee.

Levine’s Personal Motivation

“I have asthma, and that’s one of the reasons I’m concerned about the idea of preventive care,” Levine said.

“I know how important it is, and how it can save time and money and improve health. The amount of money it takes for me to make one visit to the emergency department could keep me in inhalers for months on end,” said Levine, an avid bicyclist and runner.

Levine introduced a couple other health-related bills last year, one that died in progress and one that passed by both houses of the Legislature but was vetoed by Gov. Arnold Schwarzenegger (R).

Earlier Efforts

His first attempt at encouraging employer-sponsored fitness and wellness programs was built around tax credits for employers. “That didn’t fare too well in the tax-tight climate of last year,” Levine said. That bill died in the Legislature.

The Legislature liked Levine’s bill that would have allowed community clinics to treat and manage chronic diseases, but Schwarzenegger said it would increase Medi-Cal spending and vetoed it.

“Yes, that bill would have caused more money to be spent in clinics, but in the long run it would be less money than we’re already spending in emergency rooms and hospitals,” Levine said.

“It’s really the same principal as the wellness programs,” Levine added. “If we spend a little money and time and energy up front, we can save money in the long run.”

Levine, a member of the California Task Force on Youth and Workplace Wellness, says cutbacks in school physical education and rising obesity rates are driving health care costs higher for all businesses and public programs.

“In our culture, we have to be extra conscious of making an effort to stay healthy, and that means not doing things like cutting PE classes from schools’ curriculums,” Levine said, “We should be encouraging good healthy habits in schools, get kids healthier earlier, get them into those good habits.”

Levine said the social pendulum may be swinging now toward more health consciousness.

“We’ve been fighting against a cultural tide of waiting until there’s a health problem before acting but that tide might be changing,” Levine said. “We’re seeing bills go through dealing with junk food in schools. We’re paying more attention to childhood obesity. Maybe the time is right for a bill like this.”

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