Show an ad over header. AMP

Vaccine penalties are here, and it's unclear whether they will work

25 August 2021
Dan Ackermann

Delta Air Lines' decision to charge unvaccinated employees an extra $200 per month for health insurance signals that rewards alone aren't doing enough to measurably increase rates of COVID-19 vaccination.

Why it matters: Employers are playing a central role in getting more people vaccinated, but it's unclear how much, or if, these types of penalties will help.

How it works: Federal law allows employers to charge higher health insurance premiums to workers based on a health factor only if that factor is within a "wellness program," according to Georgetown University health insurance expert Sabrina Corlette.

Yes, but: "Most [wellness] programs do not work," health policy researchers wrote in 2017. "Some raise serious legal concerns."

Delta's surcharge may not follow federal guidelines.

  • Penalties can't be so large that they'd be "coercive," according to the Equal Employment Opportunity Commission.
  • Rewards and penalties in a wellness program also can't exceed 30% of the cost of employee-only coverage, which in 2020 averaged $7,470, according to the Kaiser Family Foundation.
  • Delta's $200-a-month penalty, or $2,400 for the year, exceeds 30% of that average and would more than double the average worker contribution. Other companies have been contemplating much lower surcharges.

Delta's surcharge may not lead to behavioral change.

  • Health insurance premiums are automatically deducted from workers' paychecks, so people won't feel the penalty like they would if they had to pay $200 from their wallet.
  • Research suggests sticks over carrots can be "stigmatizing."
  • Tobacco surcharges haven't really worked.

Between the lines: The policy might not even affect all Delta employees, based on a closer read of the company's language.

  • Delta specifically said this will apply to unvaccinated workers in its "account-based health care plan," which presumably are only those who have some type of health savings account.
  • Delta did not immediately respond to questions.

The bottom line: If companies want more of their workforce vaccinated, mandates might be the clearest, legally protected option over rewards and penalties.

Transcripts show George Floyd told police "I can't breathe" over 20 times

Section2

Newly released transcripts of bodycam footage from the Minneapolis Police Department show that George Floyd told officers he could not breathe more than 20 times in the moments leading up to his death.

Why it matters: Floyd's killing sparked a national wave of Black Lives Matter protests and an ongoing reckoning over systemic racism in the United States. The transcripts "offer one the most thorough and dramatic accounts" before Floyd's death, The New York Times writes.

The state of play: The transcripts were released as former officer Thomas Lane seeks to have the charges that he aided in Floyd's death thrown out in court, per the Times. He is one of four officers who have been charged.

  • The filings also include a 60-page transcript of an interview with Lane. He said he "felt maybe that something was going on" when asked if he believed that Floyd was having a medical emergency at the time.

What the transcripts say:

  • Floyd told the officers he was claustrophobic as they tried to get him into the squad car.
  • The transcripts also show Floyd saying, "Momma, I love you. Tell my kids I love them. I'm dead."
  • Former officer Derek Chauvin, who had his knee on Floyd's neck for over eight minutes, told Floyd, "Then stop talking, stop yelling, it takes a heck of a lot of oxygen to talk."

Read the transcripts via DocumentCloud.