Bluefield Daily Telegraph, Bluefield, WV

Washington Post Features

July 17, 2013

The smoker dilemma for health insurance

Since smokers' health-care costs tend to be higher than those of nonsmokers, is it reasonable for smokers to pay higher premiums when they buy insurance through the new state marketplaces that are scheduled to open in October? A handful of states and the District of Columbia say the answer is no.

"We decided it's not in the good interests of our people" to charge smokers more, says Mohammad Akhter, chairman of the D.C. Health Benefit Exchange Authority, which is developing the District's online marketplace.

Under the 2010 Affordable Care Act, health insurers are allowed to charge smokers 50 percent higher premiums than nonsmokers for new policies sold to individuals and small employer groups.

States have the option to reduce or eliminate the variation in rates, however, and six states and the District have opted not to charge smokers more, according to the Department of Health and Human Services. A few others have limited the premium differential to less than 50 percent. Virginia will apply the full 50 percent surcharge.

Consumer advocates say charging smokers more for health insurance may be counterproductive.

"There's no evidence that charging someone a higher premium will discourage them from smoking," says Dick Woodruff, vice president of federal relations at the American Cancer Society Cancer Action Network.

It might, however, discourage someone from buying health insurance, experts say. The health law requires many plans to cover FDA-approved smoking cessation services such as counseling and medication as a preventive benefit without charging consumers anything out of pocket. If health insurance coverage seems too expensive, fewer smokers will be able to take advantage of tools to help them quit, Woodruff says.

Experts say that smokers disproportionately have lower incomes, so that a premium surcharge will hit them especially hard. Tax credits to help pay for health insurance are available to people with incomes up to 400 percent of the federal poverty level ($45,960 for an individual in 2013). But the tax credit can't be used for the tobacco surcharge.

Text Only
Washington Post Features
  • A 'wearable robot' helps her walk again

    Science is about facts, numbers, laws and formulas. To be really good at it, you need to spend a lot of time in school. But science is also about something more: dreaming big and helping people.

    April 23, 2014

  • McCain 1 House Republicans are more active on Twitter than Democrats

    Your representative in the House is almost certainly on Twitter. Your senator definitely is. But how are they using the social network? Are Democrats more active than Republicans, or vice versa? Who has the most followers on the Hill?

    April 22, 2014 1 Photo

  • Victimized by the 'marriage penalty'

    In a few short months, I'll pass the milestone that every little girl dreams of: the day she swears - before family and God, in sickness and in health, all in the name of love - that she's willing to pay a much higher tax rate.

    April 17, 2014

  • To sleep well, you may need to adjust what you eat and when

    Sleep.  Oh, to sleep.  A good night's sleep is often a struggle for more than half of American adults.  And for occasional insomnia, there are good reasons to avoid using medications, whether over-the-counter or prescription.

    April 17, 2014

  • Search teams will send unmanned sub to look for missing Malaysian airliner

    Teams searching for a missing Malaysian airliner are planning for the first time to send an unmanned submarine into the depths of the Indian Ocean to look for wreckage, an Australian official leading the multi-nation search said Monday.

    April 15, 2014

  • DayCareCosts.jpg Day care's cost can exceed college tuition in some states

    Most parents will deal with an even larger kid-related expense long before college, and it's a cost that very few of them are as prepared for: day care.

    April 11, 2014 1 Photo

  • 10 tips for surviving a severe allergy season

    My colleague Brady Dennis reported recently that the arrival of warmer weather will soon unleash a pollen tsunami in parts of the country where the winter has been especially long and cold. Here are some survival tips from Clifford W. Bassett, an allergy specialist and assistant clinical professor of medicine at the New York University School of Medicine.

    April 9, 2014

  • news_twitter.jpg Travelers fly on Air Twitter

    The enlightened age of social media has dawned over the airline industry, casting shadows over telephone call centers and on-site agents. Facebook and Twitter are racking up the friends and followers while the hold music plays on.

    April 8, 2014 1 Photo

  • To get quality care, it helps to be the right kind of patient

    I am a family physician. Sometimes I must step out of the comfort of my clinical role and into that of patient or family caregiver. Generally, these trips to the other side of the exam table inspire a fair amount of anxiety.

    April 8, 2014

  • Fast, cheap test can help save lives of many babies

    As Easley did more research into her daughter's death, she learned that a pilot program had started just months earlier at Holy Cross Hospital in Silver Spring, Md. (Easley had delivered at a different hospital in the Washington area.) The program's goal was to screen every newborn with a simple pulse oximeter test that can help detect heart problems such as Veronica's, allowing doctors to respond.

    April 8, 2014

AP Video
Business Marquee
College Sports
Pro Sports
Facebook