This Secret Obamacare 'Replacement' Lets Your Boss Invade Your Privacy AND Gut Your Paycheck

President Donald Trump and House Speaker Paul Ryan have laid out a three-step process to allegedly "repeal and replace" the misnamed Affordable Care Act (ACA) or "Obamacare." The much-lamented American Health Care Act is step one, regulatory reform is step two, and another piece of legislation would follow as step three. As it turns out, a key measure likely to be included in step three would actually expand a controversial program in Obamacare — subverting employees' genetic privacy rights and enabling employers to gut their paychecks if they don't participate in "workplace wellness" programs.

The "Preserving Employee Wellness Programs Act" (H.R. 1313) would allow companies to force employees to undergo genetic testing or risk paying a penalty of thousands of dollars, and let employers see that genetic health information. This law builds upon Obamacare's expansion of workplace wellness programs while undercutting a 2008 law which protects genetic privacy.

"What this bill would do is completely take away the protections of existing laws," Jennifer Mathis, director of policy and legal advocacy at the Bazelon Center for Mental Health Law, told Stat News. In particular, the genetic privacy and nondiscrimination protections in the law known as GINA, and in sections of the 1990 Americans with Disabilities Act, "would be pretty much eviscerated."

These protections would be undercut in order to empower businesses to strengthen their workplace wellness programs. Rather than undercutting Obamacare, this law would actually build upon a controversial impact of the ACA.

Beginning in 2014, Obamacare increased the financial incentives that employers are allowed to offer workers for participating in workplace wellness programs and achieving results, Reuters reported in 2015. Big business lobbied for these incentives, which can be levied in the form of rewards or penalties — up to 30 percent of health insurance premiums, deductibles, and other costs, and even more if the programs target smoking.

Among the two-thirds of large companies using these incentives to encourage participation in workplace wellness programs, almost a quarter are imposing financial penalties on those who opt out. Some companies even link financial incentives to specific goals such as losing weight, reducing cholesterol, or keeping blood glucose under control. The number of businesses imposing such outcome-based plans was expected to reach 46 percent in 2015.

While the general idea of being able to work out on the company's dime may sound nice, workplace wellness programs have no proven record of achieving results. Worse, the vendors involved in these programs make $8 billion in annual revenue, and have a record of cutting corners on "research" to prove their effectiveness.

At some companies, employees who declined company-specified medical screenings paid as much as $500 more per year in premiums, and lost out on company contributions of $250 to $1,500 a year. Many companies allegedly profit over these penalties.