When the Affordable Care Act takes effect Oct. 1, smokers are going to have a tough decision to make: Kick the habit or pay a smoking surcharge that could increase their health care costs by 50 percent.
The idea is that smokers can develop serious medical problems like lung cancer, heart attack and stroke and their medical treatment adds to the cost of health care.
George Washington University Law Professor John Banzhaf has argued since the 1980s that people who engage in dangerous health activities like smoking should pay more for their health insurance.
“I think this 50 percent surcharge will be one of the most effective ways of getting smokers to quit, but for those who refuse, I think it’s high time they pay the costs rather than foisting them off on the great majority of us who are non-smokers,” Banzhaf said.
Disagreement over that comes not just from smokers.
“The American Lung Association opposes the use of tobacco surcharges on health insurance and for two main reasons,” said Jennifer Singleterry of the American Lung Association. “One, It’s not a proven way to help smokers quit, and two, they can make health insurance unavailable for tobacco users.”
D.C. and a handful of states decided not to charge smokers more for their health insurance, but in Maryland and Virginia, the 50 percent surcharge on smokers goes into effect next Tuesday.
Banzhaf estimates that the smokers surcharge will increase health insurance costs by up to $12,000 annually per smoker. Maryland and Virginia employers will either pay the surcharge or pass it on to their workers who smoke.
D.C. employers are exempt, along with people who buy their own insurance in the District.