Tobacco users can be charged health insurance Marketplace premiums up to 1.5 times higher than premiums for nonusers of tobacco. Despite being charged higher premiums, low- and middle-income tobacco users receive premium subsidies identical to those received by nonusers and cannot apply the subsidy to pay for any portion of their tobacco surcharge. Premium increases over time have exacerbated the discrepancy in premium prices based on tobacco use.
Keywords: Affordable Care Act; Benchmark plans; Health insurance exchanges; Health policy; Income levels; Medicaid services; Medicare eligibility; Premiums; Private health insurance; Rating; Tobacco Use.