Surcharge For Smokers Libby Bledsoe BSN-SN NUR 4030 Introduction The Impact The Evidence Solution Implementation In 2010, when the Affordable Care Act was signed, health insurances were allowed to charge a higher premium for clients that smoked cigarettes or used tobacco products. This left smokers with the option to either kick their habit, or pay a maximum premium of 50% more than non-smokers. This surcharge can decrease the rate of illnesses related to the use of tobacco products as well as the cost of medical care. In America, tobacco use can cost about $193 billion in medical care and lost productivity. (McDonald, 2013) In addition to these, the other positive aspects of this charge include: a drop in the number of smokers in the U.S. and even premium costs for those who do not smoke. This issue impacts the economy, the individuals, and the health professionals. The impact of this issue on the macro-system is health care costs and of course the health of the population. Health insurance companies want to encourage healthy habits and keep costs down, this surcharge aids In the cost of healthcare for smokers as well as hopefully decrease the number of smokers in the country. Health care is a major part of the nation’s expenses. If this surcharge helps reduce the cost of health care, it will inevitable reduce the cost of health care for the nation. Smokers are statistically more expensive to care for that non-smokers, this surcharge can aid in a client’s smoking cessation therefore decreasing the amount of chronic illness in the country and causing less chronic care to be given and charged by medical professionals. Average Annual Health Care Costs* Tobacco-Free Tobacco User Male $3,600 $4,800 Female $5,000 $7,000 $9,000 (expectant mother) *Source: The Business Case for Coverage of Tobacco Cessation - 2012 Statistics show that 20% of Americans are smokers. Each state has the authority to enable insurance companies to charge the higher premium for smokers. The Affordable Care Act, (ACA), is beneficial for smokers or those who have the “pre-existing condition” of smoking because it now does not deny them coverage. Because of this, smokers and tobacco users will be covered and possibly be paying less than they were with previous health care plans. The New Yorks Times’ Reed Abelson states, “Tobacco users generally consume about 25 percent more health care services than nontobacco users” but before Obamacare, or ACA, the premiums were equal across the board. Premium differentials are useful for insurance companies because they support the importance of smoking cessation and the funds from the higher premiums can be used to pay for smoking termination programs. The solution to the increasing costs of health care for those who smoke is the Smoker’s Surcharge. If all states were to participate then the cost of health care would decrease exponentially as well as the number of smoking related health issues if cessation was the chosen choice for insurance clients. The solution to fix the problem of chronic health issues related to smoking and tobacco use is using incentives for cessation. People always enjoy money as well as want good health. If a client is to stop smoking, their premiums will decrease and in turn their health care costs will decrease because they will be practicing healthy habits. Another incentive is that they will be saving the money they once spent on tobacco products. The benefits to this solution is the decrease of health care costs to providers and non-smokers. Some detriments include smokers not quitting and just continuing to use tobacco products. Another detriment would be people not being honest on their forms because they know about the charge. This would not aid in the reduction of costs or smoking related illness, but just be a loophole for those who wanted to continue their unhealthy habit without paying the charge. This plan is the best choice because it is charging those who choose to smoke so that those who do not stop paying to cover the illnesses caused by tobacco use. In doing so, the cost of health care is reduced and cessation programs can be funded so the overall health of the nation improves. To implement this plan, all states should allow policy makers to administer the charge to smokers on their health insurance premiums and co-pays. Stakeholders The economy. There will be less cost to the government for health care and lost productivity because some smokers will choose to quit smoking rather than pay the extra charges. Individuals. The individual who chooses to stop smoking will see better outcomes for their own personal health as well as save money that was originally intended for tobacco products or to pay the surcharge. Health Care Providers: Health care providers will be monetarily compensated by the insurance companies for caring for patients that choose to partake in risky health behaviors that can lead to costly medical care. Evaluation The benefits of this policy will easily be seen as health care costs decrease nation wide. Providers’ documentation can be researched to see if care for chronic illnesses related to tobacco use, like COPD and asthma, has decreased. Also, the opening of cessation programs and their success will be a solid evaluation of the policy and its successful implementation.

References: Abelson, R. (2011, November 16). The smoker's surcharge. Retrieved from http://www.nytimes.com 2011/11/17/health/policy/smokers-penalized-with-health-insurance-premiums.html?pagewanted=all Advocate Health Care. (2013, April 16). 2014 tobacco surcharge frequently asked questions. Retrieved from http://benefits.advocatehealth.com/documents/Tobacco-SurchargeFAQs.pdf Alere Wellbeing. (2011). Premium differentials and surcharges powerful tobacco control strategies. Retrieved from http://www.alerewellbeing.com/_assets/cms_uploads/WP_Premium_Differentials_and_Surcharges_AWI.pdf Mcdonald, J. (2013, August 20). How obamacare premiums penalize smokers. Retrieved from http://money.msn.com health-and-life-insurance/article.aspx?post=56fc1dca-e9c4-4168-b928-e6106fb1c528