"A key protection in the Americans with Disabilities Act is that employers can't discriminate against employees based on their health status," said J.D. Piro, a principal at Hewitt Associates' health care law group. "This is a fight that's likely going to be dealt with in the courts."
In recent years, companies have offered cash, merchandise and gift cards to those who lose weight or lower their blood pressure. A few have begun refusing to hire workers who smoke. The new plans are different because employers are demanding that workers participate in health exams and have their weight checked and blood taken to screen for high cholesterol or blood sugar.
At Clarian in Indiana, employees' pay will be docked if they fail to meet certain weight ratios, cholesterol, blood pressure or if they smoke.
Brittney Manning, 29, a patient advocate at Clarian Health's Methodist Hospital in Indianapolis, said many employees were taken aback when the plan was announced last month. But she said she approves.
"I think it's fair for people to pay according to what their health care costs are," she said.
In Arkansas, Deeann Gutekunst, 42, a Benton County deputy treasurer, said she understood where the county was coming from. "If you have employees who don't care about their health," she said, "what else are you supposed to do?"
Daniel Costello writes for the Los Angeles Times.