Major companies including Delta, Google, and Goldman Sachs have announced new initiatives to spur unvaccinated employees to receive the COVID-19 shot. These include vaccine mandates for all new hires and those going back to work in-person, weekly testing, and, a somewhat controversial Delta policy: a health insurance surcharge exclusively for unvaccinated employees. Payment of the $200/month surcharge is required for these employees to stay on the company health insurance plan.

Delta has said the surcharge serves to both protect the company from revenue lost when employees are hospitalized for COVID, and to protect their staff and customers by strongly encouraging all employees to be vaccinated. Will a health insurance surcharge work to motivate vaccine-hesitant employees? And will other businesses follow Delta’s lead? We surveyed 1,000 unvaccinated Americans receiving employer health insurance to find out.

When viewing the responses by political affiliation, the results are markedly different. Fifty-eight percent of respondents identifying as Democratic said a surcharge would motivate them to get vaccinated, while only 36% of Republican-identifying respondents said the same was true for them.

A Surcharge Would Definitely Motivate 43% of Respondents, and Additional 25% Say it Could

It turns out that nearly three-quarters of those surveyed said that an extra monthly fee for health insurance could coax them into receiving the vaccine. Forty-three percent responded “yes,” that a surcharge would motivate them, while 25% said “maybe.” A surcharge would not motivate 31% of respondents.

“As they say, the vaccine is not mandatory, but if people have extra charges with their insurance due to not being vaccinated, people will surely push themselves to be vaccinated,” says Nick Schrader, insurance agent at Texas General Insurance. “This is good because the vaccine can protect the person and the people around them,”

“However, insurance companies should be considerate and check why a person doesn’t want to be vaccinated,” he continued. “If it’s valid, then exempt them from these extra charges. But if not, let them pay the additional costs.”

Political Affiliation Reveals a 22% difference

When viewing the responses by political affiliation, the results are markedly different. Fifty-eight percent of respondents identifying as Democratic said a surcharge would motivate them to get vaccinated, while only 36% of Republican-identifying respondents said the same was true for them.

Desire to Avoid a Surcharge Rises with Yearly Income

Motivation to get the vaccine increased with income. People in higher income categories reported they are more likely to avoid the surcharge by getting the shot:

  • 32% of respondents making under $75K/year said they would be motivated by a surcharge
  • 45% of respondents making between $75K/year and $125K/year said they would be motivated by a surcharge
  • 67% of respondents making over $125K/year said they would be motivated by a surcharge

Majority Would be Motivated by an Extra Cost of $100/Month or Less

While Delta is instituting a health insurance surcharge of $200/month, the majority of people surveyed stated they would be motivated by a lesser charge. Sixty-three percent stated charging an extra $100/month or less would be enough to convince them, while a staunch 17% said they would require more than $200/month to feel enough pressure to get the shot.

Mask Mandates and Losing Paid Time Off Would Also Be Effective Motivators

Major companies are introducing other workplace safety initiatives to encourage employees to receive the vaccine. We asked survey participants if these restrictions would have any effect on their decision, and more than half of them said they would.

Of those surveyed, 53% said that a mask mandate for unvaccinated employees would maybe or definitely motivate them to get the vaccine, while 56% said that losing paid time off for quarantining after a positive test result would maybe or definitely motivate them.

More Than Half of Unvaccinated Employees Report Pressure From Employers and Coworkers

When asked about other people’s attitudes toward them in the workplace, 56% of survey participants stated that they have felt pressure from their employer to get the vaccine, and 55% have felt pressure or judgment from their coworkers. When asked why they had chosen not to receive the vaccine yet, the most common responses were:

  • Waiting to see how the vaccine affected others
  • Immunocompromised and unable to get the vaccine
  • Don’t believe it would work

Differences in Reasoning by Political Affiliation

When broken down by political affiliation, the answers were slightly different by party. Democratic-affiliated respondents were more likely to say they hadn’t received the vaccine because they were immunocompromised, while the majority of Republican-affiliated respondents said they were waiting to see how the vaccine affected others.

Will More Companies Follow Delta’s Lead?

It’s true that a health insurance surcharge isn’t going to be an effective motivator for everyone, as shown by the 31% who said it would definitely not convince them. However, employees feel pressure from employers and coworkers, are affected by mask mandates and losing PTO, and may consider getting vaccinated for a charge of $100/month or less.

“​​I have had colleagues say that charging more for health insurance due to a personal choice to not get vaccinated is unconstitutional. But these overarching decisions are not about the individual at all,” says Dr. Noor Ali, Healthcare Advisor.

“The COVID-19 pandemic is a matter of social justice and if you consider the principles of public health, the overall population vaccination rates affect all of us,” says Ali. “It determines when we can safely return to traditional work, travel globally, and interact socially. I imagine the decisions made by companies like Delta also take into account population health, not just individual health.”

It will certainly be interesting to see if Delta’s decision to implement a health insurance surcharge will have any effect on their company’s vaccination rate moving forward and if other companies, big and small, will follow suit, as our data shows it could be an effective motivator.

Survey Methodology

This survey was commissioned by and conducted online by the survey platform Pollfish between August 31, 2021 and September 1, 2021. In total, 1,000 participants in the U.S. were surveyed. Participants had to pass through two screening questions to ensure they were both unvaccinated and currently receiving health insurance through their employer. In total, 47% of those surveyed work in an indoor setting with others, 16% work outdoors, 21% work from home, and 16% work in another setting, all across a wide variety of industries. Forty-one% of those surveyed are affiliated with the Democratic party, 35% with the Republican party, and 25% with a different party or are non-political.