Alabama: Extra weight = extra charge

MONTGOMERY, Ala. — Alabama, pushed to second in national-obesity rankings by deep-fried Southern favorites, is cracking down on state workers who are too fat.

The state has given its 37,527 employees a year to start getting fit — or they'll pay $25 a month for insurance that otherwise is free.

Alabama will be the first state to charge overweight state workers who don't work on slimming down. A few other states reward employees who adopt healthful behaviors.

Alabama charges workers who smoke and has seen some success in getting them to quit.

The State Employees' Insurance Board this week approved a plan to charge state workers starting in January 2010 if they don't have free health screenings.

If the screenings turn up serious problems with blood pressure, cholesterol, glucose or obesity, employees will have a year to see a doctor at no cost, enroll in a wellness program or take steps on their own to improve their health. If they show progress in a follow-up screening, they won't be charged. If they don't, they must pay starting in January 2011.

"We are trying to get individuals to become more aware of their health," said state worker Robert Wagstaff, who serves on the insurance board.

Not all state employees see it that way.

"It's terrible," said health department employee Chequla Motley. "Some people come into this world big."

Computer technician Tim Colley already pays $24 a month for being a smoker and doesn't like the idea of another charge.

"It's too Big Brotherish," he said.

The board will apply the obesity charge to anyone with a body mass index of 35 or higher who is not making progress. A person 5 feet 6 inches tall weighing 220 pounds, for example, would have a BMI of 35.5. A BMI of 30 is considered the threshold for obesity.

The board has not determined how much progress a person would have to show and is uncertain how many people might be affected because everyone could avoid the charge by working to lose weight.

A recent study suggested about half of overweight people and nearly a third of obese people have normal blood-pressure and cholesterol levels, while about a quarter of people considered to be normal weight suffer from the ills associated with obesity.

William Ashmore, executive director of the State Employees' Insurance Board, said the state will spend an extra $1.6 million next year on screenings and wellness programs but expects to see significant long-term savings.

Ashmore said research shows someone with a body mass index of 35 to 39 generates $1,748 more in annual medical expenses than someone with a BMI less than 25, considered normal.

According to the National Conference of State Legislatures, a few states offer one-time financial incentives for pursuing healthful lifestyles. Ohio workers, for instance, get $50 for having health assessments and an additional $50 for following through with the advice.

Arkansas and Missouri offer monthly discounts on premiums for employees who take health-risk assessments and participate in wellness programs to reduce obesity, stress and other health problems.

Alabama's new policy is drawing no objection from the lobbying group representing state workers.

Mac McArthur, executive director of Alabama State Employees Association, said the plan is not designed to punish employees.

"It's a positive," he said.