COMMENTARY | When the Affordable Care Act was being discussed ad nauseum in Congress, those in favor of it could often be heard saying that affordable health care should be a right for all Americans. Apparently, according to the Associated Press , what they meant was “all Americans who don’t smoke.”
Starting next year, health insurers will be allowed, under a little-noted provision, to charge up to 50 percent higher premiums to smokers. And the older the smoker, the higher the premium, with a 60-year-old smoker paying up to $5,100 more for health care. Higher premiums aren’t allowed under the law for other health concerns, such as obesity. But smoking? You bet. And what’s worse is that those purchasing coverage individually won’t necessarily have access to smoking cessation programs that are available to those who have employer-paid health care plans either.
I realize that smoking causes health problems. I realize that it increases the risk of costly — and for hundreds of thousands of people each year, fatal — diseases. But my problem isn’t about whether smoking is bad for you or not. It’s about the unfairness of the law.
If a law is going to be hailed as “something for everyone,” then it really should be available to everyone regardless of the risks they take as a matter of lifestyle. Nearly 20 percent of the adults in this nation are smokers. The higher share of those smokers fall in the lower-income bracket. So this law, which was supposed to specifically help those for whom health insurance is currently unaffordable may actually not help them at all.
Conversely, if you’re going to start ruling out people based on the risks they take in their life and the likelihood of them acquiring a costly condition because of those risks, then why just pick on smoking? How about obesity? What about alcoholics or prescription drug addicts?
While states can limit or change the so-called “smoking penalty” of Obamacare, the Associated Press quoted Robert Laszewski, a consultant who used to work in the insurance company, who said that health insurance companies may very well charge the full 50 percent. If they don’t, he explained, they will wind up with a disproportionate amount of unhealthy, older smokers when their competitors start charging the penalty. In other words, government regulations will be rippling the free market-based insurance company to the point of discriminating against people solely to keep themselves competitive with other companies. This certainly doesn’t sound like affordable healthcare for all to me.