Employers tie lower health plan premiums to tobacco screening

Chris Evans wants to qualify for a health plan with a lower deductible next year.

So the St. Paul man spent five minutes this week with a toothbrush-shaped swab tucked between his cheek and gums as part of a tobacco-use screening test at United Hospital.

The swab collected a saliva sample that will be analyzed to see if the 35-year-old is a smoker. A negative test result means Evans and his wife could save as much as $600 annually in health plan costs, an incentive that leaves a better taste in his mouth than the screening test did.

"It tastes like Alka-Seltzer or something," said Evans, who receives health benefits through his wife's Allina health system job. "It's really weird."

This year, Allina joins a national trend of companies that are linking eligibility for lower-cost health plans to results from tobacco screening tests. While some laud such programs for discouraging tobacco use, there also are concerns about a slippery slope.

"Tobacco would be the one risk factor I wouldn't mind getting draconian about," said Paul Terry, chief executive officer of StayWell Health Management, a St. Paul-based company that develops health promotion programs for employers. "But if you take that approach with smokers, will it logically follow that it's OK to do the same for people who are obese or people at risk of developing diabetes? What about people who participate in risky sports?

"It's never-ending in terms of the possibilities."