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As enacted in 1996 by a Republican Congress and a Democratic President, the HIPAA nondiscrimination rule specifically provided that it was not to be construed to prevent plan sponsors from establishing premium discounts or rebates or modifying otherwise applicable copayments or deductibles in return for adherence to programs of health promotion and disease prevention. The Bush Administration issued regulations implementing the wellness plan exception in 2006, and those regulations were largely codified by the Affordable Care Act (ACA) of 2010

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