Evidence Suggests That The ACA’s Tobacco Surcharges Reduced Insurance Take-Up And Did Not Increase Smoking Cessation

• DOI: 10.1377/hlthaff.2015.1540
• Publication Date: 2016-07-06T19:27:21Z
• Authors: Abigail S. Friedman; William L. Schpero; Susan H. Busch
• Keywords: Tobacco Industry; Health Benefits

To account for tobacco users' excess health care costs and encourage cessation, the Affordable Care Act (ACA) allowed insurers to impose a surcharge on premiums plans offered insurance exchanges, or Marketplaces. Low-income tax credits Marketplace coverage were based non–tobacco users, which means that these did not offset any costs. Thus, this policy greatly increased out-of-pocket many users. Using data 2011–14 from Behavioral Risk Factor Surveillance System, we examined effect of surcharges status smoking cessation in first year exchanges' implementation, among adults most likely purchase them. Relative smokers who faced no surcharges, facing medium high had significantly reduced (reductions 4.3 percentage points 11.6 points, respectively), but significant differences cessation. In contrast, those low showed less Taken together, findings suggest conflicted with major goal ACA—increased financial protection—without increasing States should consider potential effects when deciding whether limit than federal maximum.