WASHINGTON – Smokers – and chewers – in some states may have to pay as much as 50 percent more in premiums than nonsmokers if they sign up for insurance through state health exchanges that open next month, according to provisions in the Affordable Care Act.
Because smokers incur more health costs than nonsmokers, supporters of the rule say, it makes sense for them to pay for the higher costs. If tobacco users have to pay higher fees, their argument goes, they may be more apt to quit.
For example, a 25-year-old single man might be charged a premium of $150 a month, but if he’s a smoker, that could go up an extra $75 a month. Older people, who can be charged as much as three times more as young people, could be hit much harder if states choose to enact the new smoking rule.
Opponents of the rule argue that smoking is an addiction that can’t be ended through punishment and that smokers need insurance because of their health issues. Also, they say, there is no proof that higher costs for insurance cause smokers to quit.
The penalties will hit some groups harder than others, said Georges Benjamin, executive director at the American Public Health Association, a public health advocacy group.
“Tobacco disproportionately targets low-income communities,” Benjamin said. “They are also more likely to die prematurely for tobacco-related conditions.”
That means low-income people may be taking a harder financial hit when they may need more help, especially if they are dealing with conditions such as chronic lung cancer, he said.
Instead of penalizing smokers, states should provide therapy to help them quit, Benjamin said
Smokers can avoid the surcharge by enrolling in a tobacco-cessation program, which insurers must offer if they have a smoking surcharge.
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