The Affordable Care Act was designed to help standardize premiums within age groups, but it will allow insurance companies to charge smokers more. This provision has broad popular support. A large majority of Americans believe smokers should be charged more for health insurance, but don’t think the same penalty should be applied to individuals who are considered overweight. From Gallup:
The idea behind increasing premiums for smokers is to encourage them to quit, but making it work could be problematic. Smokers can always lie to get a lower premium, so enforcing this would require an extensive verification process – with steep penalties. It also raises some real practical questions.
How much does someone need to smoke before that person is considered a smoker? How long after a person has stopped smoking before they are no longer considered a tobacco user? What level of temporary relapse is acceptable? How would you even prove that someone used tobacco recently?
The HHS defines tobacco use “as the use of a tobacco product or products four or more times per week within no longer than the past 6 months.” Actually proving someone falls above or below this threshold without extensive monitoring would be extremely difficult.
If you want people to face a financial incentive to not smoke then raising the tax on tobacco seems to be a better option, for many reasons.