I believe it would be completely illegal (in the US) to not hire someone because you perceived them as a health expense risk.

That's probably accurate, but if 20 people apply for a position and one gets hired, is it not accurate that nobody is scrutinizing some list of 19 reasons why 19 people didn't get the position?

These kinds of things seem like there is no way to enforce them.

I don't even know if that's a thing, health insurance being more expensive for companies with older employees or whatever, but just in general. "You can't fail to hire such and such type of person because it's illegal," doesn't seem to actually have much practical ability to influence a hiring process if it wants strongly enough to not be influenced.

I haven't done any research on this and could be completely off base. Just have the same thought when I see this mentioned in general and started typing this time.

I don't disagree with the general sentiment, but I don't believe the reasoning is actually true. Generally companies pool their employees into a risk pool. Smaller ones will find a broker that does it, larger ones probably do it with their company population. But in general, the risk gets spread out enough that a couple individuals do not cause insurance to spike.

I could be wrong also, not an expert by any means, but that is basically what our HR rep told me when I inquired (not because of age but because my wife is high-risk/high-cost, depending how you look at it). I was told that was not part of the equation because of how it was setup. It could if it was a small enough business that tried to negotiate something themselves, maybe?

But we're not talking about a couple people, we're talking about a culture shift to prevent ageism. In that context, the average age definitely increases, which definitely increases the risk and premiums for that pool, what was the parent post's exact point.