healthHealth and Medicine

COVID-19: Could Companies Start Paying Employees Less If They're Unvaccinated?


Dr. Katie Spalding

Katie has a PhD in maths, specializing in the intersection of dynamical systems and number theory.

Freelance Writer

COVID-19 vaccine

Despite all the incentives being offered to those who get the vaccine, many remain unvaccinated. Image credit: Viacheslav Lopatin/

We get it: avoiding a terrifying, lonely, agonizing death from COVID-19 is nice, it’s just not as nice as a free donut. If pastries (also: not dying) aren’t your thing, you could celebrate your non-shortened lifespan with a smoke and a beer. Failing that, there’s money, college scholarships, vacations, and more up for grabs for the vaccinated, which is handy because those are all things that are best enjoyed while alive.

But for some people, all those incentives just aren’t enough. Well, when the carrot fails, there’s usually only one other option – and some employers are now thinking about hitting unvaccinated workers with up to a $50-per-month health surcharge stick.


That’s according to Mercer, an employee benefits consultancy firm that works with companies across the globe. They say that workers who refuse to get vaccinated might soon see their choice reflected in their paychecks, as their employees deduct a $20-$50 health coverage surcharge.

“Employers have tried encouraging employees to get vaccinated through offering incentives like paid time off and cash,” Wade Symons, Mercer’s regulatory resources group leader, told Forbes. “But with the Delta variant driving up infections and hospitalizations throughout the country – at the same time that vaccination rates have stalled – we have received inquiries from at least 20 employers over the past few weeks who are giving consideration to adding health coverage surcharges for the unvaccinated as a way to drive up vaccination rates in their workforce.”

Could it really happen? There is precedent, as a recent essay in the New York Times points out. The Affordable Care Act allows insurers to charge smokers up to 50 percent more than non-smokers for health coverage – a practice called tobacco rating. The rationale behind this price bump is that smoking goes against medical advice and makes you more likely to require medical care. That can be expensive, and others’ insurance premiums will be affected, even if they don’t smoke themselves – thus the cost is shifted onto the smoker.

Insurers may decide that the situation is the same with COVID-19 vaccinations: refusing to get one flies in the face of current medical advice and is likely to raise premiums when the unvaccinated get hospitalized. You could argue that it’s even riper for a surcharge than smoking, since at least cigarettes aren’t invisible and capable of mutating into new and far more contagious versions of themselves.


Neither would it be the first workplace disadvantage faced by unvaccinated folk. A few companies have already started mandating vaccination for employees hoping to return to the office – a measure which half of Americans support, so long as it’s not their employer that does it.

With the vaccine free and the cost of hospitalization potentially running to hundreds of thousands of dollars, there’s already a pretty strong financial incentive to get vaccinated. And while it’s yet to be confirmed that a health surcharge will go ahead – or even be possible, in the case of those insured by Medicare and Medicaid – it’s worth noting that among the unvaccinated, more people say they’d leave a job that introduced such a rule, rather than get the shot. With all that in mind, who knows how successful a mere $50 surcharge might be among the unvaccinated “true believers”?

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