Tobacco Surcharges on 2015 Health Insurance Plans Sold in Federally Facilitated Marketplaces: Variations by Age and Geography and Implications for Health Equity

Am J Public Health. 2015 Nov;105 Suppl 5(Suppl 5):S696-8. doi: 10.2105/AJPH.2015.302694. Epub 2015 Oct 8.

Abstract

In 2014, few health insurance plans sold in the Affordable Care Act's Federally Facilitated Marketplaces had age-dependent tobacco surcharges, possibly because of a system glitch. The 2015 tobacco surcharges show wide variation, with more plans implementing tobacco surcharges that increase with age. This underscores concerns that older tobacco users will find postsubsidy health insurance premiums difficult to afford. Future monitoring of enrollment will determine whether tobacco surcharges cause adverse selection by dissuading tobacco users, particularly older users, from buying health insurance.

MeSH terms

  • Adult
  • Fees and Charges / statistics & numerical data*
  • Health Insurance Exchanges / economics*
  • Health Insurance Exchanges / statistics & numerical data*
  • Humans
  • Insurance, Health
  • Middle Aged
  • Patient Protection and Affordable Care Act / economics
  • Patient Protection and Affordable Care Act / legislation & jurisprudence
  • Patient Protection and Affordable Care Act / organization & administration*
  • Tobacco Products / statistics & numerical data*
  • United States