DC joins several states classifying smoking as a “pre-existing medical condition” under ObamaCare

posted at 12:41 pm on April 10, 2013 by Erika Johnsen

Under ObamaCare, insurers have the option of charging smokers up to 50 percent more to cover the associated higher costs of providing them with health care — but the District of Columbia, along with several other states, have decided that any plans being sold within their exchange are prohibited from adding tobacco surcharges. That simply wouldn’t be fair, you see:

On Monday, the D.C. exchange’s executive board voted to prevent insurers from charging higher premiums to smokers than to nonsmokers — meaning nonsmokers are likely to pay modestly higher rates than if smoking surcharges were permitted. The District joins three states — Massachusetts, Rhode Island and Vermont — that have banned tobacco surcharges on their own exchanges. …

The surcharge ban applies to health plans sold within the exchange, which is set to open Oct. 1 and must be used by individuals and, if the D.C. Council endorses a previous board recommendation, employers covering up to 50 people. Larger employers purchasing outside the exchange would be able to choose plans that charge smokers more. …

In a statement, Akhter referred to tobacco use as a “pre-existing medical condition” and added that charging smokers more would be “in direct conflict with our efforts to help people quit smoking.”

Ah, the myriad joys of socialized medicine: No one person is really responsible for the costs and consequences of their decisions, while the Faceless Taxpaying Everyman (i.e., you) takes on an ever-increasing burden.

That’s pretty much the point of ObamaCare, though, isn’t it? The legislation completely corrupts the basic idea of health insurance — i.e., pricing out risk — by forbidding insurers from doing so accurately and charging accordingly, and the states nixing smoking surcharges from their exchanges are just hurrying that along. As Kevin Williamson puts it at NRO:

As expected, the definition of “preexisting condition” is proving infinitely malleable, with behaviors born again as conditions. If smoking is a condition, then drug addiction is a condition, self-mutilation is a condition, a penchant for BASE jumping is a condition, juggling ampules of penicillin-resistant syphilis — practically anything qualifies as a condition under such a plastic understanding. …

Obamacare is designed to destroy the insurance market. Markets do not function without prices, and Obamacare ensures that prices will not be allowed to emerge. There is a medical price associated with smoking, but the District of Columbia has decided to suppress that price by law. Pretending that smoking has no relationship with health-care costs does not make it so — it is only a way to push costs around in a way that is agreeable to the likes of Barack Obama, converting a system that prices risk into a system of entitlements.


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I was attacked by this cigarette, it jumped in my mouth and made me suck. I’m a VICTIM I tell you!

kirkill on April 10, 2013 at 12:44 PM

Don’t worry, in Command Economics, market principles are irrelevant.

All is well.

Trust the State.

OhEssYouCowboys on April 10, 2013 at 12:45 PM

They were born that way. Smoking isn’t a choice.

blammm on April 10, 2013 at 12:45 PM

So you can’t charge someone extra insurance if they choose to smoke. But if they choose to own a gun, that’s different?

What a screwed-up world liberals are building, where giving yourself cancer is subsidized, but someone who exercises a constitutional right is penalized. The only model that fits such a Bizarro-world is that libs want total government dependence and control, and an elimination of self-reliance and individual responsibility.

Socratease on April 10, 2013 at 12:47 PM

Why not? Any other decision would imply that people should somehow be individually (rather than collectively) responsible for the consequences of their own actions. As I understand the policies of this administration, that would be completely inconsistent with everything they stand for…

morganfrost on April 10, 2013 at 12:47 PM

What about ignorance, because that scourge appears to be contagious.

RovesChins on April 10, 2013 at 12:47 PM

You know, I thought liberals hated smokers, just like they hate fat people, being a drain on everyone’s healthcare expenses and the entire healthcare system.

You know, I have a pre-existing condition. Its a fever and the only cure for it is more cowbell. So Obamacare will give me more cowbell?

Lay-Z on April 10, 2013 at 12:48 PM

The Communists should go the whole 9 yards and submit CommieCare to a series of 5 year plans.

OhEssYouCowboys on April 10, 2013 at 12:50 PM

Is obesity considered a pre-existing condition, too? Because I swear pastry and lattes constantly jump in my mouth and make me chew and swallow against my will, and it makes me too distressed to work off the calories.

I’m a VICTIM too!!

hawkeye54 on April 10, 2013 at 12:50 PM

Protect the tax money at all costs.

meci on April 10, 2013 at 12:50 PM

The Communists should go the whole 9 yards and submit CommieCare to a series of 5 year plans.

I don’t think they are quite ready for that yet. Give ‘em time to secure their statist utopia. Then maybe the 5 year plans will be in vogue again.

hawkeye54 on April 10, 2013 at 12:51 PM

Oh, good! As a smoker, I can mess with liberals like Bloomie who ban me from smoking in NYC public parks. If this is declared a ‘pre-existing medical condition’, like an inhaler for people with asthma, Mayor Nanny ends up losing.

I love this!

Conservatism tends toward the same goal: maximum liberty with little government as possible.

Liberals policies, on the other hand, will inevitably come into conflict among their own.

Liam on April 10, 2013 at 12:52 PM

Protect the tax money at all costs.

Nobody to do it. All they want to do is raid the tax money for all costs.

hawkeye54 on April 10, 2013 at 12:52 PM

If smoking is a ‘preexisting medical condition,’ then bans on smoking run afoul of the Americans With Disabilities Act.

Resist We Much on April 10, 2013 at 12:54 PM

So I can light up a cigar in a public building again? What do you mean NO? I have RIGHTS, mothaflocka, and you are marginalizing my alternative lifestyle! See you in court.

Bishop on April 10, 2013 at 12:55 PM

If smoking is a ‘preexisting medical condition,’ then bans on smoking run afoul of the Americans With Disabilities Act.

Resist We Much on April 10, 2013 at 12:54 PM

Don’t you EVER stop, you Big Blue Meanie? :-)

Liam on April 10, 2013 at 12:56 PM

I wonder if the time will come, when those who oppose Communism will have a pre-existing condition that will serve as grounds to eliminate their having any access to UtopiaCare?

OhEssYouCowboys on April 10, 2013 at 12:57 PM

What about sesquipedalian’s inability to find love?

Chuck Schick on April 10, 2013 at 12:59 PM

charging smokers more would be “in direct conflict with our efforts to help people quit smoking.”

Economic incentives… how do they work?

AndrewsDad on April 10, 2013 at 12:59 PM

If people in D.C. were motivated by higher insurance premiums to stop smoking, D.C. would see their revenue from their $3.00/pack tobacco tax decline. So better to keep people smoking and have everyone else pick up the health care tab.

It’s a Democrat win win.

Curtiss on April 10, 2013 at 1:00 PM

The District joins three states — Massachusetts, Rhode Island and Vermont

I can’t put my finger on it. What do DC and these three states have in common….

How long before NY and California jump on this bandwagon?

hopeful on April 10, 2013 at 1:01 PM

Smokers already pay THOUSANDS of dollars a year extra in the offensive and criminal cigarette taxes, along with the price increases that resulted from that insane $250 billion settlement.

You can’t keep bleeding smokers dry from every single angle.

As to this pre-existing condition BS … of course it’s cr@p, but no health insurance companies do any actuarial analyses of lifestyles in order to price the insurance. If people want actuarial analyses of everything people do in order to have their insurance priced properly (which is how it should be) then do that – not just to smokers, though. And stop with these insane smoking and tobacco taxes if you are looking to screw us over everywhere else. Enough, already.

ThePrimordialOrderedPair on April 10, 2013 at 1:02 PM

Obamacare is designed to destroy the insurance market. Markets do not function without prices, and Obamacare ensures that prices will not be allowed to emerge.

Well and accurately stated.

Lourdes on April 10, 2013 at 1:02 PM

If it wasn’t happening to my country, I’d find it fascinating to watch a country descend, day-by-day, into the State-run abyss.

OhEssYouCowboys on April 10, 2013 at 1:04 PM

If smoking is a ‘preexisting medical condition,’ then bans on smoking run afoul of the Americans With Disabilities Act.

Resist We Much on April 10, 2013 at 12:54 PM

Then it also follows that smokers have a right to access cigarettes, which, as with birth control, means that insurance companies must provide free cigarettes to smokers.

If we can get free cigarettes to just one smoker, then we have to try.

Curtiss on April 10, 2013 at 1:06 PM

Under ObamaCare, insurers have the option of charging smokers up to 50 percent more to cover the associated higher costs of providing them with health care — but the District of Columbia, along with several other states, have decided that any plans being sold within their exchange are prohibited from adding tobacco surcharges. That simply wouldn’t be fair, you see:

Obama proclaimed, amidst his “Memphis Party” at the White House recently, that he wants Booker T and the MGs’ “Green Onion” to accompany him instead of “Hail To The Chief” in his appearances. I imagine KOOL cigs had a lot to do with all of this…

Instead of “Green Onion,” what should accompany Obama is a rendition of “Smoke, Smoke, Smoke That Cigarettebecause tomorrow the taxpayers will pay for your invalid and hospital care.

Lourdes on April 10, 2013 at 1:07 PM

If smoking is a ‘preexisting medical condition,’ then bans on smoking run afoul of the Americans With Disabilities Act.

Resist We Much on April 10, 2013 at 12:54 PM

Then it also follows that smokers have a right to access cigarettes, which, as with birth control, means that insurance companies must provide free cigarettes to smokers.

If we can get free cigarettes to just one smoker, then we have to try.

Curtiss on April 10, 2013 at 1:06 PM

Obama and his Democrats: destructing personal responsibility, personal accoutability, one disasterous, outrageous distortion of reality at a time.

Lourdes on April 10, 2013 at 1:09 PM

How long before NY and California jump on this bandwagon?

hopeful on April 10, 2013 at 1:01 PM

They won’t. Too much tax money is involved. Here in NY, the cigarette tax is $4.35, plus sales tax on the full amount of $7.62 per pack of my brand.

There is no way liberals are going to let that cash cow go by the wayside.

What is going to funnier is when those liberals who want pot legalized see the taxes they have to pay for their high. It might well take time, but the politicians are just slavering over how much more money they can get.

Later, and inevitably, the black market will end up being cheaper.

Liam on April 10, 2013 at 1:13 PM

Then it also follows that smokers have a right to access cigarettes, which, as with birth control, means that insurance companies must provide free cigarettes to smokers.

If we can get free cigarettes to just one smoker, then we have to try.

I’m all for it if we can get the right to access free pot included.

hawkeye54 on April 10, 2013 at 1:14 PM

Utter madness.

changer1701 on April 10, 2013 at 1:14 PM

ThePrimordialOrderedPair on April 10, 2013 at 1:02 PM

So I should pay higher premiums so you don’t have to? Even though that means that you are more likely to get a whole bunch of expensive to treat diseases?

Smoking is a choice, your choice. It costs alot. You could choose to quit. A person with a history of breast cancer can’t choose to undo that.

I do agree that insurance companies could charge based on how well people take care of themselves but I think you’d end up paying more based on that metric as well.

hopeful on April 10, 2013 at 1:15 PM

How long before NY and California jump on this bandwagon?

hopeful on April 10, 2013 at 1:01 PM

Actually, NRO says that CA and CT have already done so.

blammm on April 10, 2013 at 1:15 PM

Click through to the WaPo article. It gets darkly hilarious; the right side of the page is a scare-tactic ad from the CDC (!!!!) showing how smoking is dangerous to your health (and by extension, expensive).

Darth Hippie on April 10, 2013 at 1:15 PM

What is going to funnier is when those liberals who want pot legalized see the taxes they have to pay for their high. It might well take time, but the politicians are just slavering over how much more money they can get.

Right. Leftist politicians could care less about the “unintended” consequences and costs of legalized pot as long as they get their “fair” share of taxes from its sales.

hawkeye54 on April 10, 2013 at 1:16 PM

As to this pre-existing condition BS … of course it’s cr@p

ThePrimordialOrderedPair on April 10, 2013 at 1:02 PM

I’m a smoker most of my life. Of course it’s crap! I don’t have a ‘pre-existing condition’. I smoke. That’s about the end of it.

Liam on April 10, 2013 at 1:17 PM

If we can save one child by giving them cigarettes then we have a moral duty to try.

Do you freaks have any idea what’s it’s like to be a smokester but have to hide it from everyone, to not be yourself in public, to not be able to express your pride equally with non-smokers?

Bishop on April 10, 2013 at 1:18 PM

As to this pre-existing condition BS … of course it’s cr@p,

but no health insurance companies do any actuarial analyses of lifestyles in order to price the insurance. If people want actuarial analyses of everything people do in order to have their insurance priced properly (which is how it should be) then do that – not just to smokers, though. And stop with these insane smoking and tobacco taxes if you are looking to screw us over everywhere else. Enough, already.

ThePrimordialOrderedPair on April 10, 2013 at 1:02 PM

Bingo.

If you are a rock climber, you don’t have a pre-existing condition, you are engaging in a lifestyle choice.

If you fall and permanently injure yourself, then you have a pre-existing condition.

MichaelGabriel on April 10, 2013 at 1:18 PM

I’m sure that DC, MA, RI, and VT have hefty cigarette taxes on the order of $5 a pack to discourage people from smoking, and save some health-care expenses due to Romneycare in MA. But if smokers are more likely to get lung cancer than non-smokers, they can’t be charged more for health insurance than non-smokers for high-risk behavior?

What about all those laws passed by liberal states banning smoking in restaurants and public places? If smokers can’t pay higher insurance premiums, then cigarette taxes are unfair discrimination against smokers, and they have a 14th Amendment right to smoke in public and pollute the air non-smokers breathe.

Don’t get me wrong–I have never smoked, and I appreciate the anti-smoking laws which give me the right to breathe clean air in public places, airplanes, and restaurants. But people CHOOSE to smoke, and millions of people who had smoked have chosen to quit, so why shouldn’t people who continue to poison themselves pay more for health insurance?

Steve Z on April 10, 2013 at 1:19 PM

I have a condition called, “I have to play music very loud at any and all hours of every day”. Don’t knock on my door and tell me to turn it down, it’s my pre-existing nature, I was born this way.

/.

Lourdes on April 10, 2013 at 1:19 PM

So if its not fair to charge a smoker more for insurance, is it fair to charge more for cigarettes?

Gatsu on April 10, 2013 at 1:20 PM

I fundamentally disagree with Obamacare in its entirety. The government should have no role in health insurance or health care.

However, if for a hypothetical exercise, we are going to assume the government is going to regulate the health insurance market, I can understand the logic here. There are a million different activities people can do to make them more or less likely to require health care. Why should those who smoke be charged more while those who eat fatty foods not? Or those who — gasp! — buy 32 ounce sodas?

Shump on April 10, 2013 at 1:21 PM

The fix is to charge smokers more, but to have half of the surcharge be paid for by the tobacco companies and the Indian reservations.

After all, if you sell an addictive product, legally or otherwise, then you are partly responsible for the results of that addiction.

The other responsible party is the individual smoker.

unclesmrgol on April 10, 2013 at 1:23 PM

DC joins several states classifying smoking as a “pre-existing medical condition” under ObamaCare

First they redefined “racist” and I didn’t say anything because I was a fan of Obama.

Then they redefined “marriage” and I didn’t say anything because I was “hip”.

Then they redefined “pre-existing medical condition” and…

DethMetalCookieMonst on April 10, 2013 at 1:24 PM

no but it does set up gov to regulate smoking out of existence. After all if its a drug like coccanie it need to be down away with…….

unseen on April 10, 2013 at 1:11 PM

They could already do that under the Pure Food and Drug Act of 1906, the Food, Drug, and Cosmetic Act, along with its numerous amendments, if they wanted to, because tobacco is sold in interstate commerce and nicotine and other additives used in cigarettes are ‘drugs’ or ‘dangerous substances’ that can be regulated or banned.

They do not ‘regulate tobacco products out of existence’ because they want the tax revenues raised through their sale.

How else would they pay for S-CHIP? /

Resist We Much on April 10, 2013 at 1:24 PM

I kind of doubt that Obamacare’s provision for allowing smokers to be charged more will stand anyway. Think about it… it is perfectly reasonable for free citizens to choose what kind of risk pool they’d like to share, or whether they’ll interact with one at all. Obamacare mandates our choices for us.

We are NOT free to choose our level of coverage or who we’d like to share the risk with. So, it’s not right or proper to charge more to some than to others, particularly not when there’s no way to accurately predict what each person is going to cost. There’s still quite a bit of controversy as to whether smokers cost more. Some studies suggest they actually cost less, as smokers die an average of ten years earlier than non-smokers.
http://usatoday30.usatoday.com/news/health/2009-04-08-fda-tobacco-costs_N.htm

It’s one thing for private companies and private citizens to make discriminatory contractual agreements. It’s quite another when it’s government-sponsored discrimination. It’s not just fatties and smokers who engage in risky behavior. It’s kids with skateboards, and people with slippery bathtubs, and non-monogomous sexual practices. Are we willing to do a comprehensive risk analysis for every American and see what his individual price ought to be?.. from babies to the geriatric? And how to we control the behavior of all those poor unfortunate souls within 200% of poverty level that we’re going to be forced to subsidize? If I’m the one paying the bill for chain-smoking fatties, base jumpers, mountain climbers, crackheads, and the stretched rectums of sodomites, don’t I have a RIGHT to tell them to stop their risky behavior?

See, this is WHY we didn’t want government involved in our heathcare to begin with.

Murf76 on April 10, 2013 at 1:25 PM

Isn’t this a little passive agressive?

On the one hand, we’ve been running smokers out of all public places–relegating them to huddling in small smoking sections outdoors. On the other hand, we’re sending them the signal that smoking is not their fault.

Maybe the key is that liberals think that because homosexuality is not a choice, neither is smoking. Or maybe, if homosexuality is more like smoking, the first 100 times it’s a choice. After that, it’s an addiction.

Will smoking buddies now be entitled to smoking-partner benefits so that when the primary smoker dies, the surviving smoking-partner will be entitled to a defined-benefit pension payable by Social Security or, as likely, the decedent’s public-employee employer. More costs for taxpayers.

BuckeyeSam on April 10, 2013 at 1:25 PM

Smoking is a choice, your choice. It costs alot. You could choose to quit. A person with a history of breast cancer can’t choose to undo that.

hopeful on April 10, 2013 at 1:15 PM

The whole point of Obamacare is to eliminate personal responsibility for one’s lot in life. If you “can’t” do anything about anything (replace “anything” with whatever your latest complaint is), the taxpayers must do it for or to you for ______ (fill in the blank as to your politically-correct rationalization).

Lourdes on April 10, 2013 at 1:25 PM

I’m still mystified how smoking can be considered a “pre-existing condition”. No one is born smoking. You don’t show up for your first year medical exam with a carton of Camels.

Lourdes on April 10, 2013 at 1:26 PM

Maybe the key is that liberals think that because homosexuality is not a choice, neither is smoking. Or maybe, if homosexuality is more like smoking, the first 100 times it’s a choice. After that, it’s an addiction.

Will smoking buddies now be entitled to smoking-partner benefits so that when the primary smoker dies, the surviving smoking-partner will be entitled to a defined-benefit pension payable by Social Security or, as likely, the decedent’s public-employee employer. More costs for taxpayers.

BuckeyeSam on April 10, 2013 at 1:25 PM

That seems to be the right interpretation of this mess.

Lourdes on April 10, 2013 at 1:28 PM

Expect this soon: taxpayers must pay for artificial insemination of smokers. While they’re smoking, I guess.

Lourdes on April 10, 2013 at 1:28 PM

California is moving to make homosexuals inability to have children a ‘pre-existing condition’ that must be covered under insurance. Under the new proposal, homosexuals are ‘infertile’ if they cannot have children by engaging in sexual relations. It doesn’t matter if, say, the two guys could both impregnate women. What matters is that they cannot impregnate one another. Thus, it is a ‘pre-existing medical condition.’

Biology be damned.

Resist We Much on April 10, 2013 at 1:29 PM

If smoking is a ‘preexisting medical condition,’ then bans on smoking run afoul of the Americans With Disabilities Act.

Resist We Much on April 10, 2013 at 12:54 PM

That was my first thought upon reading this.

Solaratov on April 10, 2013 at 1:30 PM

Soon any hue, other than white, will be a pre-existing condition. How can you argue against it?

Schadenfreude on April 10, 2013 at 1:33 PM

Same smokers will be put on the death panels.

Schadenfreude on April 10, 2013 at 1:34 PM

I’m still mystified how smoking can be considered a “pre-existing condition”. No one is born smoking. You don’t show up for your first year medical exam with a carton of Camels.

Lourdes on April 10, 2013 at 1:26 PM

Speak for yourself, bigot.

Bishop on April 10, 2013 at 1:34 PM

What about sesquipedalian’s inability to find love?

Chuck Schick on April 10, 2013 at 12:59 PM

http://www.fantasydoll.com.au/gallery

NSFW!

Solaratov on April 10, 2013 at 1:35 PM

I’m still mystified how smoking can be considered a “pre-existing condition”. No one is born smoking. You don’t show up for your first year medical exam with a carton of Camels.

Lourdes on April 10, 2013 at 1:26 PM

Speak for yourself, bigot.

Bishop on April 10, 2013 at 1:34 PM

Ha! I know, I know, you shared a big ceegahr with your pediatrician after your first vaccinations, I know, I know.

:)

Lourdes on April 10, 2013 at 1:38 PM

The fix is to charge smokers more, but to have half of the surcharge be paid for by the tobacco companies and the Indian reservations.

After all, if you sell an addictive product, legally or otherwise, then you are partly responsible for the results of that addiction.

The other responsible party is the individual smoker.

Wrong, wrong, WRONG! Why the hell should tobacco companies bear ANY responsibility? It’s my flippin’ decision to smoke, nobody elses.

Otherwise, it’s partly S&W’s responsibility when someone uses a gun in a crime!!!

Sheesh.

dalewalt on April 10, 2013 at 1:40 PM

Smokers are already denied certain transplants and the like. As was stated above by Murf, it is not even certain that smokers cost more than non-smokers for health care – as smokers die earlier and faster than others.

If people want smokers to be charged in accordance with the actual health care costs of smoking then they need to, first, find out what those costs are. If they’re less than smokers should pay less. And smokers shouldn’t be paying much into SS since it seems universally acknowledged that most smokers will never collect much of anything from SS. How about that calculation?

I have no problem paying for what I do but along the same vein, while I smoke I am still in better shape than 99% of the population and have not even had any medical expenses over the past twenty years other than a torn meniscus (unrelated to smoking, obviously) while most of the people I know are seeing doctors regularly, getting prescriptions for all sorts of things, and generally costing tons of money. An anecdotal view, of course, but when it comes to MY PERSONAL HEALTH INSURANCE COSTS and people’s desire to charge me extra for some generalized idea of risk, then my particular and specific history needs to be taken into account.

Also, people with a history of heart problems in the family would have to be charged extra, mental issues in the family, living in dangerous areas, etc. I guess most of the people here jumping on smokers are all for that, too …

ThePrimordialOrderedPair on April 10, 2013 at 1:44 PM

These ding-dongs don’t really want to exempt smokers from extra charges as they don’t want another contradiction they have to deal with. Its all the unintended results of trying to do Universal health care. As far as I know they are just copying socialized medicine which can’t charge anything extra for smoking. These countries just raise the taxes on cigarettes to pay for what smokers cost in the universal system which is what you would see here in the US.

Conan on April 10, 2013 at 1:45 PM

What IS insurance, anyway ??? I get ZERO benefits out of my FIRE Insurance, and I’ve had it for like 30 years !!!!

oh, and WHY IS HEALTH INSURANCE* *STILL* DISTRIBUTED THROUGH EMPLOYERS ??? Think of how much business could boom if they didn’t have to worry about this !!!

Erica, please advance this cause, thanks.

williampeck1958 on April 10, 2013 at 1:48 PM

I’m still mystified how smoking can be considered a “pre-existing condition”. No one is born smoking. You don’t show up for your first year medical exam with a carton of Camels.

Lourdes on April 10, 2013 at 1:26 PM

You are not born crippled due to a car accident, or with cancer, or with a heart attack, or with dementia, either. That’s just a poor argument.

The whole point of a risk pool is to even out costs over a larger population. So what if you add smoking into the mix.

when it comes to MY PERSONAL HEALTH INSURANCE COSTS and people’s desire to charge me extra for some generalized idea of risk, then my particular and specific history needs to be taken into account.

ThePrimordialOrderedPair on April 10, 2013 at 1:44 PM

Absolutely correct. Some smokers are healthy, some are not. Some live long lives, some don’t. Charging ALL smokers a surcharge is as much a gross generalization as charging none, perhaps more so.

This story is a big nothingburger.

Mr. Arkadin on April 10, 2013 at 1:53 PM

Want a surcharge for smoking? Fine. As long as you add a surcharge for being obese.

RightWired on April 10, 2013 at 1:59 PM

when it comes to MY PERSONAL HEALTH INSURANCE COSTS and people’s desire to charge me extra for some generalized idea of risk, then my particular and specific history needs to be taken into account.

ThePrimordialOrderedPair on April 10, 2013 at 1:44 PM

It is risky behavior. I have an auto-immune disease and through no fault of my own for years insurances have been able to charge me more. Furthermore, I take steriods for the auto-immune disease which sometimes leaves me overweight at times. I am always able to take the weight off, but not while I am on the treatment for steriods. Insurance would also ding me for being overweight even though there is mitigating circumstances as to why I put on that weight.

melle1228 on April 10, 2013 at 2:27 PM

This is all about race. Minorities are much more likely to be smokers now that whites. A surcharge on smokers would certainly fall most heavily on minorities. Can’t have that in DC.

And they really don’t want people to quit smoking. They need the tax revenue.

rockmom on April 10, 2013 at 2:59 PM

They could already do that under the Pure Food and Drug Act of 1906, the Food, Drug, and Cosmetic Act, along with its numerous amendments, if they wanted to, because tobacco is sold in interstate commerce and nicotine and other additives used in cigarettes are ‘drugs’ or ‘dangerous substances’ that can be regulated or banned.

They do not ‘regulate tobacco products out of existence’ because they want the tax revenues raised through their sale.

Resist We Much on April 10, 2013 at 1:24 PM

No, they can’t. Under the The Family Smoking Prevention and Tobacco Control Act, which gives the FDA regulatory power over tobacco products, the government is prohibited from banning tobacco products.

BacaDog on April 10, 2013 at 3:04 PM

No, they can’t. Under the The Family Smoking Prevention and Tobacco Control Act, which gives the FDA regulatory power over tobacco products, the government is prohibited from banning tobacco products.

BacaDog on April 10, 2013 at 3:04 PM

The government CAN regulate additives in tobacco and, if the tobacco companies fail to meet the requirements, what happens to their product?

They are ‘regulated out of existence.’

Resist We Much on April 10, 2013 at 3:14 PM

No, they can’t. Under the The Family Smoking Prevention and Tobacco Control Act, which gives the FDA regulatory power over tobacco products, the government is prohibited from banning tobacco products.

BacaDog on April 10, 2013 at 3:04 PM

Except the Act does allow, specifically, for the ban of certain tobacco products, such as flavoured cigarettes.

The flavouring is an additive.

The ban on flavoring applies to any product meeting the definition of a “cigarette” according to section 3(1) of the Federal Cigarette Labeling and Advertising Act. This includes any tobacco that comes rolled such as cigarettes and cigars, and added to this definition in the Family Smoking Prevention and Tobacco Control Act is any tobacco with the purpose to be rolled such as rolling tobacco.

Resist We Much on April 10, 2013 at 3:17 PM

I get ZERO benefits out of my FIRE Insurance, and I’ve had it for like 30 years !!!!

You pay for fire insurance? Why not just wait until your house is on fire, then get it. They can’t turn you down for “pre-exising conditions”, can they???

You wouldn’t believe how much I’m saving on car insurance.

taznar on April 10, 2013 at 3:26 PM

Our current insurance system blunts the responsiblity for the costs of individual’s actions by forcing us to purchase policies that cover a myriad of services that are not applicable to all individuals. Insurance should cover catastrophic events, not normal life events.

Wendya on April 10, 2013 at 3:28 PM

No, they can’t. Under the The Family Smoking Prevention and Tobacco Control Act, which gives the FDA regulatory power over tobacco products, the government is prohibited from banning tobacco products.

BacaDog on April 10, 2013 at 3:04 PM

The government CAN regulate additives in tobacco and, if the tobacco companies fail to meet the requirements, what happens to their product?

They are ‘regulated out of existence.’

Resist We Much on April 10, 2013 at 3:14 PM

Not so very long ago in the great scope of centuries — back in the 1920′s through about the 1950′s in rural area homesteads — people grew their own tobacco. And that doesn’t include the centuries of tobacco-growing in the US by people who sold it as a cash crop every year (some of my family were tobacco and rice growers from the pre-Revolutionary years forward)…

Anyway, tobacco is really easy to grow annually and takes a routine easily learned to harvest and dry it out such that it can be chopped up and rolled for smokin’ later. You don’t have to grow acres of the stuff, just a small patch in any family farm plot. It’s easy enough to grow and so easy, in fact, that if a few plants are grown, you end up with really huge leafy plants in a few months if you keep the bugs away (simple enough to do).

Lourdes on April 10, 2013 at 4:10 PM

Our current insurance system blunts the responsiblity for the costs of individual’s actions by forcing us to purchase policies that cover a myriad of services that are not applicable to all individuals. Insurance should cover catastrophic events, not normal life events.

Wendya on April 10, 2013 at 3:28 PM

Added to that, individual states have mandated to the insurance companies what they must cover. It is a beast caused by big government. There hasn’t been anything remotely free about the health care market since the end of WWII.

Time to break the monopoly up and divorce government from health care.

tom daschle concerned on April 10, 2013 at 4:12 PM

Lourdes on April 10, 2013 at 1:26 PM

You are not born crippled due to a car accident, or with cancer, or with a heart attack, or with dementia, either. That’s just a poor argument.

The whole point of a risk pool is to even out costs over a larger population. So what if you add smoking into the mix.

(…)

Mr. Arkadin on April 10, 2013 at 1:53 PM

I realize it’s an insurance scheme by Obamacare for financial incentives/reasons but it’s a ludicrous exploitation of the concept of “pre-existing condition” simply because smoking is intentional and also persistent before it does damage to anyone (you have to keep at it for a while and with frequency intentionally to do damage to yourself and others).

Falling down, breaking bones, accidental damages…these are happenstance occurrences that produce harms to people but with smoking, you have to decide to do it, then do it and do it persistently for a long time to produce damage to yourself/others.

So it’s an exploitation of the MEDICAL concept of what a “pre-existing condition” is…and akin to alcoholism, in my experience and views, also any other substance abuse condition.

I smoked intensely for about thirteen years — chain smoker and I really wanted to smoke despite knowing the dangers — and could not stop after *finally* in my last two years of smoking realizing I couldn’t stop, couldn’t control the stuff, that it was and I was addicted to nicotine.

I stopped and it was God’s miracle that I did. No kidding, no exaggeration. No patches, no programs, nothing: I stopped one day after my morning cigarette two days after asking God to do for me what I realized I could never do for myself and that was to stop smoking something that was bigger than me: cigarettes.

Truly, it was a miracle, God did it. I stopped after thirteen years, kept a whole carton in my kitchen drawer for over a decade afterward until someone unknown to me pilfered them; and I’ve never smoked since or wanted to.

It is, however, behavioral — not accidental, not inherited, nothing you’re born with, it’s a behavioral issue.

Lourdes on April 10, 2013 at 4:17 PM

Related:

Here’s a photo from the US Depression years…

guy tending to tobacco plants.

Just a few of these large-leafy plants would be more than enough for one person to smoke for a year after drying/curing, chopping up the leaves. Tobacco plants are easy to grow in a family farm, as I wrote earlier.

Lourdes on April 10, 2013 at 4:23 PM

Another random photo showing the size of tobacco plants and how just an acre or so of these plants produces a good cash crop. And just a few of these plants provides more than enough for one person to smoke year-round.

Lourdes on April 10, 2013 at 4:27 PM

The government CAN regulate additives in tobacco and, if the tobacco companies fail to meet the requirements, what happens to their product?

They are ‘regulated out of existence.’

Resist We Much on April 10, 2013 at 3:14 PM

True. They have banned “characterizing flavors” in cigarettes – except menthol. But, they cannot ban natural tobacco or its constituents.

Also, any product on the market at the time of the act is grandfathered. New products or even a change to an existing product (filter, paper, etc) have to go through a rigorous process to get approval.

BacaDog on April 10, 2013 at 4:33 PM

I kind of doubt that Obamacare’s provision for allowing smokers to be charged more will stand anyway. Think about it… it is perfectly reasonable for free citizens to choose what kind of risk pool they’d like to share, or whether they’ll interact with one at all. Obamacare mandates our choices for us.

We are NOT free to choose our level of coverage or who we’d like to share the risk with. So, it’s not right or proper to charge more to some than to others, particularly not when there’s no way to accurately predict what each person is going to cost. There’s still quite a bit of controversy as to whether smokers cost more. Some studies suggest they actually cost less, as smokers die an average of ten years earlier than non-smokers.
http://usatoday30.usatoday.com/news/health/2009-04-08-fda-tobacco-costs_N.htm

It’s one thing for private companies and private citizens to make discriminatory contractual agreements. It’s quite another when it’s government-sponsored discrimination. It’s not just fatties and smokers who engage in risky behavior. It’s kids with skateboards, and people with slippery bathtubs, and non-monogomous sexual practices. Are we willing to do a comprehensive risk analysis for every American and see what his individual price ought to be?.. from babies to the geriatric? And how to we control the behavior of all those poor unfortunate souls within 200% of poverty level that we’re going to be forced to subsidize? If I’m the one paying the bill for chain-smoking fatties, base jumpers, mountain climbers, crackheads, and the stretched rectums of sodomites, don’t I have a RIGHT to tell them to stop their risky behavior?

See, this is WHY we didn’t want government involved in our heathcare to begin with.

Murf76 on April 10, 2013 at 1:25 PM

I can’t believe you heartless Rethuglicans aren’t concerned about stretched-rectum syndrome!

slickwillie2001 on April 10, 2013 at 4:50 PM

Absolutely correct. Some smokers are healthy, some are not. Some live long lives, some don’t. Charging ALL smokers a surcharge is as much a gross generalization as charging none, perhaps more so.

Mr. Arkadin on April 10, 2013 at 1:53 PM

Then you could argue that it’s wrong for car insurance companies to charge 17 year old boys more for insurance than 30 women pay. Not all 17 year old boys will crash their cars; most probably won’t but as a group, they are higher risk. Same with smokers.

hopeful on April 10, 2013 at 5:10 PM

They won’t. Too much tax money is involved. Here in NY, the cigarette tax is $4.35, plus sales tax on the full amount of $7.62 per pack of my brand.

There is no way liberals are going to let that cash cow go by the wayside.

Liam on April 10, 2013 at 1:13 PM

You misunderstand.

If you penalize smokers, as NY and Cali do; you get FEWER of them paying the massive taxes that you ‘re spending as fast as you can.

If, like D.C. Rhode Island, etc. you REWARD smokers you get MORE of them… still paying those sweet sweet massive per-pack taxes.

Of course in reality the black market will soak up most of your revenue either way; but since they’re pretending that can’t happen rewarding smokers would increase the milk from their cash cow… wouldn’t it?

gekkobear on April 10, 2013 at 5:58 PM

There’s still quite a bit of controversy as to whether smokers cost more. Some studies suggest they actually cost less, as smokers die an average of ten years earlier than non-smokers.

Which makes sense if you’re arguing from a “total cost for medicare per person” argument… but this does NOT apply for a “per year cost of healthcare premium pricing” analysis.

For the years a smoker is alive; their healthcare will likely be more expensive than for a non-smoker… just like the average health care for a year for a 73 year old is going to (on average) be higher than for a 22 year old.

You’re correct that the lifetime costs and the claims that “if we stop smoking Medicare will save billions” is spurious… but that doesn’t mean the statistical analysis used to calculate the premium of a 50 year old smoker as higher than a 50 year old non-smoker (for the costs from 50 to 51) is invalid.

It’s the cost from 50 -> death where you see the smoker save money… which affects the Medicare argument appropriately, but not the “single year premium of health care” argument.

Yes, I’m a smoker… but I do a lot of math.

OTOH if you have the pre-existing condition of “I have [any chronic/deadly illness]” then your per year cost of health care will be SCADS higher than mine was last year (1 doctor’s visit, my every few years physical).

If that person can’t be charged more even with the knowledge they’ll cost more… why can I as a smoker? I will cost more than average person my age on an average year; but you’ve just made the worst case scenario not something they can charge for; why do they get a free ride?

gekkobear on April 10, 2013 at 6:05 PM

The financial argument they’re making is wrong. Because smokers tend to die younger than nonsmokers the actual long term health care costs of smoking is less than nonsmoking heart disease or cancer.

halfbaked on April 10, 2013 at 6:09 PM

charging smokers more would be “in direct conflict with our efforts to help people quit smoking.”

Well, actually, one of the most effective determents to smoking in my clinical experience has been increasing costs-cigarrettes cost more, people smoke less. Charge smokers more for insurance, less to spend on cigarettes.

The financial argument they’re making is wrong. Because smokers tend to die younger than nonsmokers the actual long term health care costs of smoking is less than nonsmoking heart disease or cancer.

halfbaked on April 10, 2013 at 6:09 PM

As stated above, they cost more per year they’re alive. It’s a reasonable argument that smokers should pay less for SS because they’ll draw less cause they’ll die sooner, but they will cost more in healthcare per year. They pay into healthcare by the year, so they should pay more per year. once they die, they no longer cost anything, but they no longer pay in.

talkingpoints on April 10, 2013 at 10:40 PM

Even if one disregards utterly the studies suggesting smokers cost less, that still doesn’t dispense with the fact that the GOVERNMENT is guilty of discrimination between citizens.

Murf76 on April 11, 2013 at 7:02 AM

Ahhh, yes, the evil smoker..the best cash cow evah, well until all 50 states legalize pot…

NHElle on June 18, 2013 at 3:10 PM