I think by now, the whole country knows about Alex Lange, the four month old Colorado baby who was denied health insurance by Rocky Mountain Health Plans because of his weight. He's 17 pounds, which puts him in the 99th percentile for weight - although he's also near the top of the charts for height. Alex is exclusively breast fed, and by all accounts is a very healthy baby. Rocky Mountain Health Plans reversed their decision following a national outcry, and has established new underwriting guidelines for infants that don't take obesity into account.
One of the major aspects of health care reform that has gained a lot of traction this year involves doing away with medical underwriting on individual health insurance policies, and would require health insurance carriers to accept all applicants, regardless of health history. Obesity is considered a pre-existing condition by all of the individual health insurance carriers in Colorado. Obviously applying these standards to a healthy, breastfeeding baby is ill advised, but I believe it makes sense for adults.
The guidelines are currently pretty lenient when it comes to weight. Most carriers start to increase the premiums on their policies if an applicant has a BMI of around 30 - which is the cutoff for obesity, according to the CDC. Being overweight, but not obese (BMI of 25 to 29.9) doesn't result in a rate increase at all with many carriers. So a 5'5" female can weigh up to 180 pounds and still qualify for a standard rate with many of the individual health insurance carriers in Colorado, assuming she is a non-smoker and doesn't have any other pre-existing conditions.
I'm curious to see what happens to underwriting regarding obesity and tobacco use as health care reform moves forward. Both of these factors are known to increase health care costs. They're also factors that each person can control - not saying that it's easy, but it can be done. I can see the benefit to making sure that everyone gets accepted for health insurance, regardless of weight, as it's counterproductive for society as a whole to have people who are uninsured. But I believe that it makes sense for obese applicants, and tobacco users, to pay more for their health insurance in order to offset the higher claims they are statistically likely to have.
I'm curious to hear what our readers think about this topic. Should obese applicants pay more for their health insurance than normal weight applicants? What about smokers? Does this amount to something akin to a regressive tax, since lower income people are more likely to be overweight, and also more likely to be smokers? Should income then be taken into consideration when setting health insurance premiums?