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Older smokers priced out of Obamacare?
Helen Heinlo smokes outside of a coffee shop in Belmont, Calif. on June 11, 2007. / AP
Washington Millions of smokers could be priced out of health insurance because of tobacco penalties in President Obama's health care law, according to experts who are just now teasing out the potential impact of a little-noted provision in the massive legislation.
The Affordable Care Act — "Obamacare" to its detractors — allows health insurers to charge smokers buying individual policies up to 50 percent higher premiums starting next Jan. 1.
For a 55-year-old smoker, the penalty could reach nearly $4,250 a year. A 60-year-old could wind up paying nearly $5,100 on top of premiums.
Younger smokers could be charged lower penalties under rules proposed last fall by the Obama administration. But older smokers could face a heavy hit on their household budgets at a time in life when smoking-related illnesses tend to emerge.
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Workers covered on the job would be able to avoid tobacco penalties by joining smoking cessation programs, because employer plans operate under different rules. But experts say that option is not guaranteed to smokers trying to purchase coverage individually.
Nearly one of every five U.S. adults smokes. That share is higher among lower-income people, who also are more likely to work in jobs that don't come with health insurance and would therefore depend on the new federal health care law. Smoking increases the risk of developing heart disease, lung problems and cancer, contributing to nearly 450,000 deaths a year.
Insurers won't be allowed to charge more under the overhaul for people who are overweight, or have a health condition like a bad back or a heart that skips beats — but they can charge more if a person smokes.
Starting next Jan. 1, the federal health care law will make it possible for people who can't get coverage now to buy private policies, providing tax credits to keep the premiums affordable. Although the law prohibits insurance companies from turning away the sick, the penalties for smokers could have the same effect in many cases, keeping out potentially costly patients.
"We don't want to create barriers for people to get health care coverage," said California state Assemblyman Richard Pan, who is working on a law in his state that would limit insurers' ability to charge smokers more. The federal law allows states to limit or change the smoking penalty.
"We want people who are smoking to get smoking cessation treatment," added Pan, a pediatrician who represents the Sacramento area.
Obama administration officials declined to be interviewed for this article, but a former consumer protection regulator for the government is raising questions.
"If you are an insurer and there is a group of smokers you don't want in your pool, the ones you really don't want are the ones who have been smoking for 20 or 30 years," said Karen Pollitz, an expert on individual health insurance markets with the nonpartisan Kaiser Family Foundation. "You would have the flexibility to discourage them."
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Considering the many years before them in which to be a burden on the healthcare system, I think younger smokers ought to be penalized deep and hard as well. Nothing like heavy financial stress to make them rethink the wisdom of quitting tobacco use. Once quit, their premiums should be lightened. Think of it as an additional charge for being stupid and a reward for wising up.
If you are obese and have unhealthy eating or activity habits, you have a higher risk for gallstones, type 2 diabetes, high blood pressure, high cholesterol and triglycerides, coronary artery disease (CAD), a stroke, and sleep apnea, among other conditions.
Children who are obese are at risk for many of the same long-term health problems.
Or drinkers?
The long term effects of alcohol consumption range from cardioprotective health benefits for low to moderate alcohol consumption in industrialized societies with higher rates of cardiovascular disease to severe detrimental effects in cases of chronic alcohol abuse. High levels of alcohol consumption are associated with an increased risk of alcoholism, malnutrition, chronic pancreatitis, alcoholic liver disease, and cancer. In addition damage to the central nervous system and peripheral nervous system can occur from chronic alcohol abuse. Long-term use of alcohol in excessive quantities is capable of damaging nearly every organ and system in the body. It also can cause Stroke, Cognition and dementia, Essential tremor, and Mental health effects.
So really if your going to punish those that smoke and ruin their health by choice as you say, why not punish everyone who does horrible things to their bodies by choice.