September 7, 2021

Higher Premiums for Unvaccinated

Kelly O’Reilly President and CEO, OAHP

Higher premiums make sense for those who don’t lower their COVID risk

As Ohio struggles through a fourth wave of COVID-19 infections, with masks again required in schools and stores and in-person events thrown into doubt, one fact is clear: The COVID vaccine is our surest hope of ending this bad movie.

Yet millions of our neighbors and co-workers are declining to get vaccinated and the issue has become politically controversial. Little wonder, then, that employers, schools and other institutions are moving to strongly encourage or even require vaccination.

The COVID vaccine is our surest hope of ending this bad movie.
Kelly O’Reilly President and CEO, OAHP

Some state and local governments want to prohibit vaccine mandates, but employers have a powerful alternative: requiring unvaccinated employees to pay more for their company-provided health insurance. Delta Airlines made headlines recently with an announcement that employees who aren’t vaccinated by Nov. 1 will face a $200 monthly surcharge on their health-care premiums.

The company also is requiring unvaccinated employees to wear masks indoors at work be tested for COVID-19 every week.

A surcharge like this isn’t unheard of; it’s essentially the same as higher health- or life-insurance premiums for people who smoke. It is a reasonable way for insurers to prepare for the easily foreseeable result of members not getting vaccinated: more COVID hospitalizations. It also appears to be effective. A Delta Airlines official told Bloomberg Law that employee vaccinations went from 11 in one day to 55 the day after the policy was announced.

Vaccination doesn’t guarantee that a person won’t contract COVID-19, especially in light of the highly transmissible Delta variant of the virus. But it very nearly guarantees that person won’t have a case serious enough to send him or her to the hospital, and that makes vaccination important not only for public health, but also to limit health-care costs.

Virtually all patients admitted to hospitals with serious COVID cases in recent months have been unvaccinated. And every one of those hospitalizations represents $30,000 to $50,000 in costs that could have been avoided easily, with vaccines that are widely available, proven effective and free.

But as of Sept. 2, only 61% of Ohioans who are eligible for the vaccines (those 12 and older) had received the first shot and 56% had completed vaccination. Nationwide, only 53% were fully vaccinated.

Here in Ohio, with help from the Ohio Association of Health Plans (OAHP), the state’s six Medicaid Managed Care plans are partnering in an all-out effort to get more Medicaid members vaccinated. All plans are offering $100 gift cards for any member who receives the first vaccination shot by Dec. 31. They also have agreed to extra compensation for health-care providers who handle walk-in vaccinations. They’re staging mass vaccination events in communities and urging members through email, phone calls and texts to get vaccinated.

This collaborative effort contrasts sharply with House Bill 248, a proposal in the General Assembly that would ban vaccine mandates by schools and other institutions, not only against COVID-19, but also against a host of other infectious diseases including polio, measles and flu.

OAHP strongly opposes H.B. 248 for the needless risk it would impose on Ohioans, especially our children. And we applaud all those who are working to increase vaccination, not make it harder.