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:

Trend: Percentage of Americans Who Say It Is Justifiable to Set Higher Insurance Rates

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.

Jon Walker

Jon Walker

Jonathan Walker grew up in New Jersey. He graduated from Wesleyan University in 2006. He is an expert on politics, health care and drug policy. He is also the author of After Legalization and Cobalt Slave, and a Futurist writer at