The Patient Protection and Affordable Care Act of 2010 (ACA) increased the maximum rewards that group health insurance plans (including employers who self-insure) may offer in their wellness programs, with the goal of incentivizing healthy behaviors such as weight loss among the obese and smoking cessation. In this essay, I describe the history and intention of such programs, and make the following three points: (1) In principle, incentivizing healthy behavior can reduce external costs and help people with time-inconsistent preferences stick to their resolutions; (2) there are problems with the design of this portion of the ACA that will limit its effectiveness in achieving these goals; and (3) financial rewards for healthy behaviors have a mixed record to date, and thus many practical design features need to be resolved to improve the effectiveness of such programs.