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by giraffe_lady 111 days ago
The first time I heard about it was hospital groups and other healthcare employers around 2010. Like you said it was originally an optional bonus/discount but even then there were explicit plans to make it mandatory over some years.

The timing as I remember it matches up with ACA passing (optional) and going into effect (mandatory) so may have something to do with health insurer costs related to that. But I don't know enough about it to guess more, just a suspicion.