Add another exclamation point to the hazards of smoking: smokers will pay a lot more for Health insurance as provisions of the Patient Protection and Affordable Care Act (ACA) kick in.
Tobacco use kills more than 440,000 Americans a year and costs about $96 billion in health care, according to the Centers for Disease Control and Prevention.
The ACA allows insurers to charge smokers a premium surcharge of up to 50% when they buy through health insurance exchanges – online marketplaces where individuals and businesses employing up to 50 people can shop for coverage.
The surcharge could end up erasing subsidies for low-income smokers who can’t afford to buy coverage on their own, For example, someone who can pay only $3,000 a year for a health plan that costs $6,000 would qualify under the ACA for a $3,000 subsidy to cover the difference – but the tobacco surcharge would kick the cost back up to $6,000.
Congress added the surcharge to discourage unhealthy behavior and give insurers a way to help control costs associated with this risky (but voluntary) habit. However, there might be better ways to discourage smoking, such as higher taxes on cigarettes or expanded public awareness campaigns.
Rick Curtis, president of the Institute for Health Policy Solutions, believes the surcharge would do most harm to those the ACA was designed to help – people with modest means in need of medical care. As he sees it, “Those who are totally hooked after many years and are older (and those kinds of people are more expensive to cover and often need more medical care) have two bad choices – go without Health insurance or get coverage and be impoverished.”