Although insurers are applying lower surcharges on members who smoke than what's allowed under the Affordable Care Act, tobacco users have still been less able than other consumers to afford health coverage, according to a new study published in Health Affairs.
Under the ACA, insurers can add as much as 50 percent to tobacco users' premiums, but most plans sold on the health insurance exchanges charged consumers who smoke a median of about 10 percent more.
"It seems as if smokers don't actually--at least in the age range that the health insurance exchanges are targeting--use 50 percent more in terms of costs for healthcare," Cameron Kaplan, the study's lead author and assistant professor of preventive medicine at the University of Tennessee Health Science Center, told Kaiser Health News.
Rather, smokers use about 10 percent more healthcare, which is why insurers priced tobacco users' premiums about 10 percent higher than other non-smoking consumers. Kaplan added that pricing strategy was smart if insurers "want to attract people into their plan," particularly since exchange shoppers who smoke so far appear "to be the people who avoid using health services."
The problem, however, is that subsidies are calculated based on premium costs before tobacco surcharges are added, so the federal financial aid often isn't enough for some smokers to afford health plans.
The study also noted that seven states--Missouri, Ohio, Maine, Nevada, New Hampshire, New Mexico and Nebraska--had insurers charging at least 25 percent higher premiums for consumers who smoke.
And although some supporters of the tobacco surcharge believe a more expensive premium could help curb smoking rates, Kaplan said there's "really not enough data" so far to support an argument either way.