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."