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Should employers charge unvaccinated workers more for health insurance?

Pilots talking after exiting a Delta Airlines flight at the Ronald Reagan National Airport.
Pilots talk after exiting a Delta Airlines flight at the Ronald Reagan National Airport. Delta Air Lines will charge employees who don’t get the COVID-19 vaccine more for heath insurance.
(Getty Images)

Delta Air Lines will charge employees that don’t get the COVID-19 vaccine more for heath insurance.

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Delta Air Lines recently announced recently it would charge employees an additional $200 a month for health insurance if they don’t get the COVID-19 vaccine.

Delta said the average cost for a not fully vaccinated employee who got the virus and had to stay in the hospital was $50,000.

Some experts say the solution is a good one, because it gives the worker a choice — instead of requiring it. Critics have said it’s a slippery slope of starting to charge employees more who have cancer, are overweight or other scenarios.

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Q: Should employers charge workers without the COVID-19 vaccine more for health insurance?

Kelly Cunningham, San Diego Institute for Economic Research

YES: Personal responsibility should be a consideration in one’s health care coverage. Discounts for insurance are readily available for certain behaviors, such as not smoking or getting annual routine physicals. Coverage for health conditions beyond individual control are different from actions putting one’s health at greater risk. Employers offering group health coverage should be able to impose surcharges for workers engaging in unhealthy behavior and increasing the organization’s health care costs. Getting vaccinated can be considered the same.

Phil Blair, Manpower

YES: It should be an option. The rationale behind the surcharge is that health care costs are going up about $200 per month per unvaccinated employee due to the high costs of COVID-19. This is so obvious to me when you hear that 95 percent of the hospitalized and ICU patients have not been vaccinated. Like measles and mumps, COVID-19 is preventable, or at least able to be minimalized, merely by getting vaccinated. There are exemptions for health care issues and the religions that are opposed, but they are a very small percent of the population. It will get even more real when those who are unvaccinated lose their jobs due to companies wanting to protect their workers and their families from unvaccinated people.

Gary London, London Moeder Advisors

YES: There is nothing unprecedented about an insurance surcharge. If you have speeding tickets your auto insurance premium rises. Over time (and assuming no more speeding) your rates normalize. This “carrot and stick” approach should apply to non-vaxxers just as it applies to speeders, smokers, and others whose abuse of their health tends to cost the rest of us, in our health and in our pocketbooks. A COVID-19 premium might actually be economically beneficial to non-claimants.

Alan Gin, University of San Diego

NO: It seems to make sense that those who put more of a burden on health care should pay a higher premium or penalty. But this undermines the whole concept of group insurance and the pooling of risk, where the cost of high-risk individuals is offset by lower-risk people in the pool. One worry is that the practice could expand into other areas, with penalties for smokers, women of child-bearing age, older workers, etc., which could make health insurance unaffordable for some people.

Bob Rauch, R.A. Rauch & Associates

YES: But it is a slippery slope as this could lead to charging anyone who has a pre-existing condition. Those who “choose” to not be vaccinated could be construed to be similar to those who “choose” to smoke. Smokers pay more for life insurance and drivers with a DUI pay more for auto insurance. Ergo, a company may charge more for non-vaccinated employees based on those employees being a potential liability to the company.

Austin Neudecker, Weave Growth

YES: Employers pay for your health care costs either directly (most large companies) or based on the likelihood and history of their employees’ medical bills. While I believe this system is fundamentally flawed, it seems fair that employers incentivize vaccinations to avoid unnecessary hospitalizations. Further, unlike a vice indulged outside of work, spreading a disease that could substantially harm other employees or customers has a direct impact on the broader business.

James Hamilton, UC San Diego

YES: Employers have every right to charge a price that covers costs. Unvaccinated workers can raise the company’s health costs directly for the unvaccinated and indirectly if they infect other workers, as well as expose businesses to lawsuits from customers. I am nevertheless bothered that the statement by Delta’s CEO seems to go beyond simply covering added costs, and may have a paternalistic element of, “we know best what’s best for you.”

Chris Van Gorder, Scripps Health

YES: More than 90 percent of hospitalized COVID-19 patients end up sicker, in the hospital longer and in the ICU more often than the vaccinated patients. The cost of paying for someone to get that level of treatment is much higher — a cost that could have been mitigated if the employee chose to get a vaccine. And beyond the health risk to themselves and cost to their employer, unvaccinated employees create higher risk in the workplace for other employees and customers, too.

Norm Miller, University of San Diego

YES: If insurers are going to start charging more for health insurance for the unvaccinated then employees should bear that extra cost, as this is a controllable decision on the part of the employee. I see this as no different from anyone knowingly putting themselves at risk and then somehow expecting society at large to cover for them when the “I never expected the flood to be this bad” happens for those buying oceanfront at sea level.

Jamie Moraga, IntelliSolutions

Not participating this week.

David Ely, San Diego State University

NO: If the objective of the organization is to increase the share of their workforce that is vaccinated, a mandate will be more effective than imposing a surcharge on unvaccinated workers. An insurance surcharge will not be sufficient motivation for one who is strongly opposed to receiving a shot. Implementation will be difficult since a worker’s insurance premium may need to be adjusted over time based on whether a booster shot is received.

Ray Major, SANDAG

NO: This is a bad idea. Period. Setting a precedent whereby workers are charged different amounts for health insurance based upon vaccine or other lifestyle status is the consummate “slippery slope.” It opens up the door to companies charging more for health insurance for any reason. This could include additional premiums for people who have a chronic health problem, high BMI, don’t exercise or have unhealthy lunch habits. This has 1984 written all over it.

Lynn Reaser, Point Loma Nazarene University

YES: Two good reasons to support the policy. First, these employees should bear more of the cost since unvaccinated people are now driving COVID-19 hospitalizations and their expense. COVID-19 vaccines are readily available at no cost. Second, higher insurance premiums could push more employees to become vaccinated. People respond to incentives — both positive and negative. It is also imperative that individuals are accountable for their decisions, including any costs or harm they may impose on others.

Reginald Jones, Jacobs Center for Neighborhood Innovation

NO: Employers want workers vaccinated. This serves to protect the workforce and clientele. Rather than increase health insurance charge, mandate the vaccine. Law is on the side of private companies opting to mandate vaccines, so long as they provide an exemption for medical or sincerely held religious reasons. Hiking insurance rates for non-vaccinated workers is not the answer. More critical is to halt workplace spread of COVID-19 and variants. An infected workforce halts productivity — impacting profitability.

Have an idea for an EconoMeter question? Email me at phillip.molnar@sduniontribune.com.

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