Big Tobacco and Anti-Tobacco Team Up Against Health Care Act Smokers’ Surcharge

In this article, Sarah Kliff explains that the big tobacco companies and certain anti-cancer groups are allied against a provision in the Affordable Care Act that allows health insurers to charge 50% higher premiums to smokers. (In real terms, the 50% smokers' surcharge could be much higher because the Act also bars government subsidies to help smokers pay the premium surcharge, although those subsidies will be available to help pay premiums of low-income people generally.) No doubt the provision is intended to encourage people to quit smoking.

Big Tobacco is against it because a law that makes smoking more costly could cut into tobacco sales. Kliff says that health groups are against it because it could discourage smokers from getting health insurance, and, the groups explain, smokers tend to be relatively low-income people to begin with. The article says that the smoker surcharge is something of an anomaly because the Affordable Care Act seeks to curtail other group premium disparaties, demanding equal premiums between men and women and limiting disparate premiums for older people. Kliff also notes that the lobbying against the provision is going on at the federal and state levels, because states have power under the ACA to bar the tobacco surcharge. Absent repeal or modification, the surcharge will go into effect in 2014.