Though the legalization of recreational marijuana inColorado and Washington is causing complications for HRdepartments, industry experts say it's not having a big impact oninsurance and premiums — at least not yet.

The fact that wwmillions of Americans now have access to legal,often very-potent weed has generally sparked no discussion orchanges in the questions people are asked when they sign up forcoverage, experts say.

“It's had no impact on our policies toward health insurance, norare we discussing any aspects of that. It's a nonissue for us,”says Neil Waldron, chief marketing officer and vice president ofstrategic initiatives for Rocky Mountain Health Plans. “The only[time we would make a change] is if there were a regulation to comeout at the state level or at the federal level related to howhealth insurance is or is not to be provided to people who smokemarijuana. We don't currently have a policy, and if you smokemarijuana we don't even know that, nor do we ask that.”

The Colorado Uniform Application for Small Group Health Plans,which is used by most providers in the state, does ask aboutillegal drug use as part of a question that also asks aboutalcoholism and chemical dependency, but Vincent Plymell,communications manager for the Colorado Division of Insurance, saysthere are no plans to change the question to clarify that marijuanais no longer an illegal drug under state law.

And though Colorado law allows a plan increase of up to 15percent for those who use tobacco, he says, there have been nodiscussions of a similar provision for marijuana, which becamelegal in the state on Jan. 1.

“The law is very clear on what you can rate on,” Waldron says.“You can rate on tobacco; you can rate on age and geographicalarea, but you can't rate on other things” — including alcohol andmarijuana use.

In Washington, meanwhile, where the first retail marijuana shopsopened July 8, insurance insiders say it's too early to tell whateffect, if any, the availability of legal pot will have on healthinsurance.

Kara Klotz, public affairs and social media manager for theWashington State Office of the Insurance Commissioner, notes that“health insurance plans that are regulated by the WashingtonInsurance Commissioner are very limited in what types ofhealth-related questions they can ask their subscribers, and theyare not allowed to charge certain subscribers more than othersubscribers” — including those who use alcohol or tobacco.

While legal marijuana is, so far, a nonissue with carriers,medical marijuana — now legal in 20 states, including Colorado — isfacing an identity crisis of its own. Still illegal under federallaw, medical marijuana is not covered by any health insuranceplans, says Susan Pisano, vice president of communications atAmerica's Health Insurance Plans.

“Marijuana is still considered a schedule 1 drug under thecontrolled substance act,' Pisano says, “which means that,according to their definition, there is no recognized medical useand a high potential for abuse.”

Additionally, Pisano said there continues to be concern about alack of evidence about the benefits of medical marijuana as well asconcern about its potential harm.

Fast Eddy Aki'a smokes a joint as thousands gather tocollectively light up at 4:20 p.m. in Civic Center Park inDenver. ©thinkstock.com/Marc Piscotty

One area in which medical marijuana is given at least tacitapproval is life insurance.

In an article on LifeHealthPro last year, author Brad Cumminsnotes that patients need to disclose their medical marijuana use upfront or risk being denied, but once that has occurred, “somecompanies will rate applicants as a standard smoker, giving themdouble the rates of those as a nonsmoker, while others are okay foroccasional use. The rules and ratings vary widely.”

Most carriers charge nonsmoker rates to those who use marijuanaoccasionally, and a smoker's rate for those who use it more thanonce a week.

Marijuana may not yet be a concern for insurers, but somedoctors believe that pot use eventually will need to be discussedin the same breath as tobacco use. Philadelphia-area physicianBindu Kumar, in a January op-ed in Philadelphia magazine, citededucational campaigns around tobacco use and their effectiveness instopping kids from smoking.

“I'm not equating tobacco to pot,” she said, “but there areclearly still health issues that can arise.”

Kumar also wrote about the potential risks pot present in theworkplace, for example: “an employee shows up to work high onmarijuana, with visibly impaired judgment and makes a catastrophicerror that leads to harm. Are we OK with this? Of course not — it'sno different than alcohol-related incidents,” she said. “However,all this talk about legalizing marijuana has to be balanced with anongoing discussion about its possible impact on concentration,judgment, memory and reaction time — all of which can be impairedwith use.

“We can't just think of the recreational enjoyment,” Kumar said.“Employers need to factor this issue in to their human-resourcepolicies; physicians will need to consider marijuana usage similarto alcohol when assessing their patients; and public-healthofficials will have to re-brand their tobacco campaigns to includepot.”

– Greg Glasgow