Though the legalization of recreational marijuana in Colorado and Washington is causing complications for HR departments, industry experts say it's not having a big impact on insurance 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 or changes in the questions people are asked when they sign up for coverage, experts say.
“It's had no impact on our policies toward health insurance, nor are we discussing any aspects of that. It's a nonissue for us,” says Neil Waldron, chief marketing officer and vice president of strategic initiatives for Rocky Mountain Health Plans. “The only [time we would make a change] is if there were a regulation to come out at the state level or at the federal level related to how health insurance is or is not to be provided to people who smoke marijuana. We don't currently have a policy, and if you smoke marijuana 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 about illegal drug use as part of a question that also asks about alcoholism and chemical dependency, but Vincent Plymell, communications manager for the Colorado Division of Insurance, says there are no plans to change the question to clarify that marijuana is no longer an illegal drug under state law.
And though Colorado law allows a plan increase of up to 15 percent for those who use tobacco, he says, there have been no discussions of a similar provision for marijuana, which became legal 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 geographical area, but you can't rate on other things” — including alcohol and marijuana use.
In Washington, meanwhile, where the first retail marijuana shops opened July 8, insurance insiders say it's too early to tell what effect, if any, the availability of legal pot will have on health insurance.
Kara Klotz, public affairs and social media manager for the Washington State Office of the Insurance Commissioner, notes that “health insurance plans that are regulated by the Washington Insurance Commissioner are very limited in what types of health-related questions they can ask their subscribers, and they are not allowed to charge certain subscribers more than other subscribers” — 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 — is facing an identity crisis of its own. Still illegal under federal law, medical marijuana is not covered by any health insurance plans, says Susan Pisano, vice president of communications at America's Health Insurance Plans.
“Marijuana is still considered a schedule 1 drug under the controlled substance act,' Pisano says, “which means that, according to their definition, there is no recognized medical use and a high potential for abuse.”
Additionally, Pisano said there continues to be concern about a lack of evidence about the benefits of medical marijuana as well as concern about its potential harm.
Fast Eddy Aki'a smokes a joint as thousands gather to collectively light up at 4:20 p.m. in Civic Center Park in Denver. ©thinkstock.com/Marc Piscotty
One area in which medical marijuana is given at least tacit approval is life insurance.
In an article on LifeHealthPro last year, author Brad Cummins notes that patients need to disclose their medical marijuana use up front or risk being denied, but once that has occurred, “some companies will rate applicants as a standard smoker, giving them double the rates of those as a nonsmoker, while others are okay for occasional use. The rules and ratings vary widely.”
Most carriers charge nonsmoker rates to those who use marijuana occasionally, and a smoker's rate for those who use it more than once a week.
Marijuana may not yet be a concern for insurers, but some doctors believe that pot use eventually will need to be discussed in the same breath as tobacco use. Philadelphia-area physician Bindu Kumar, in a January op-ed in Philadelphia magazine, cited educational campaigns around tobacco use and their effectiveness in stopping kids from smoking.
“I'm not equating tobacco to pot,” she said, “but there are clearly still health issues that can arise.”
Kumar also wrote about the potential risks pot present in the workplace, for example: “an employee shows up to work high on marijuana, with visibly impaired judgment and makes a catastrophic error that leads to harm. Are we OK with this? Of course not — it's no different than alcohol-related incidents,” she said. “However, all this talk about legalizing marijuana has to be balanced with an ongoing discussion about its possible impact on concentration, judgment, memory and reaction time — all of which can be impaired with use.
“We can't just think of the recreational enjoyment,” Kumar said. “Employers need to factor this issue in to their human-resource policies; physicians will need to consider marijuana usage similar to alcohol when assessing their patients; and public-health officials will have to re-brand their tobacco campaigns to include pot.”
– Greg Glasgow
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