Promotional photo from Scale Back Alabama
Promotional photo from Scale Back Alabama - 
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KAI RYSSDAL: Dieting and watching what you eat can be a challenge. There's nothing more boring than carrots for a snack when what you'd really like is a Snickers bar or something. So the state of Alabama's offering a stick to go with that carrot. A monthly chunk added to your health insurance bill if you don't at least try to trim down. From WBHM in Birmingham, Alabama, Tanya Ott has the story.

Tanya Ott: Here's a number for you: Obesity costs the U.S. health care system $93 billion a year. But honestly, the number I wanted to know when I first heard about this policy was my body mass index. So I went to the Web.

My height is 5-foot, 2 inches. And my weight is 164 pounds. We hit "compute BMI" and the answer's 30.

Under the new plan, state employees in Alabama who have a BMI of more than 34 and don't address their problems with cholestoral or blood pressure, will have to pay $25 more a month for health insurance.

ALAN MONHEIT: This is not really good public policy.

Alan Monheit is a health economist at the University of Medicine and Dentistry of New Jersey. He says several things determine someone's predisposition to being overweight -- from how far they commute to genetics. But Eric Finkelstein, author of "The Fattening of America: How the Economy Makes Us Fat," thinks genetics are overblown. He says for many people, the issue is behavior.

Eric Finkelstein: I think the question that people need to ask is, Are we better off with a strategy that may discriminate against some subset of individuals but that, on net, may substantially improve the health and the financial health of the country. And I think that's really what this law boils down to.

Finkelstein says it's no different than private health insurance where rates are based on risk. Alabama will spend more than $1.5 million on medical screenings and health education the first year of the program.

I'm Tanya Ott for Marketplace.