Where there's smoke, there's no insurance

Smoker may stay uninsured unless he quits.
Associated Press
Sep 12, 2013


Eric Jones has an incentive to end his trips to the party store for cigarette tubes and tobacco, the roll-your-own supplies used to fill his pack-a-day habit.

The 40-year-old has no health insurance from his $9-an-hour job at an ice-manufacturing plant in Lansing. Under the federal health care law, he's eligible for help from the government to buy insurance.

But to qualify, he'll almost certainly have to quit smoking.

A baseline insurance plan could cost Jones, who makes $22,000 working seasonally from February to November, $775 a year in premiums. Or he could pay no premiums in the cheapest plan, which has higher deductibles and copayments.

Yet if he keeps smoking, he could face an annual financial penalty ranging from $1,600 to $1,900 that will make coverage unaffordable. The numbers were estimated using the online Kaiser Health Reform Subsidy Calculator.

"I'd rather have health coverage than cigarettes, if it comes down to it," Jones said.

The law requires insurers to accept all applicants regardless of pre-existing medical problems. But it also allows them to charge smokers premiums that are up to 50 percent higher than those offered non-smokers — a way for insurers to ward off bad risks.

Jones is not without health problems. He said he should be taking medications for gout, high blood pressure, high cholesterol and severe acid reflux but instead just suffers through his conditions.

"I can't afford them," he said. "So I just don't take them."

Jones, who first smoked at age 12, has tried quitting. He stopped about four years ago with no help from nicotine patches or gum. But he started up again this year.

"Everybody around me was smoking except my wife. Everywhere. All my friends," he said.

Nearly one of every five U.S. adults smokes. That share is higher among lower-income people such as Jones, who are more likely to work in jobs that do not offer health insurance and are a major reason the law was enacted. The smoking penalty has drawn criticism for effectively pricing people out of insurance.

Jones already is worried that he won't be able to afford insurance even if he does quit. He has trouble paying the rent. He takes the bus from rural Charlotte 20 miles each way to work in the city every day.

Yet if Jones keeps smoking, he said there is no way he could afford the estimated $1,600 yearly smoking penalty in the least expensive plan, equaling 7 percent of his income. Michigan is not among the few states that have banned tobacco surcharges on their insurance marketplaces.

At least in the interim, Jones may get some relief.

A glitch will limit penalties that insurers can charge smokers until it's fixed next year. The government's computer system has been unable to accommodate a provision that prevents companies from charging older customers more than three times what they charge younger adults and the provision letting smokers be charged higher premiums.

In addition, Jones and other smokers newly insured through exchanges or Medicaid will benefit from requirements that tobacco cessation treatments be covered.

Experts say with the prevalence of high tobacco taxes and workplace smoking bans, those able to quit more easily already have done so. Long-time smokers such as Jones — who wants to quit but has found an inexpensive way to keep the habit — usually need nicotine replacement therapy and classes.

Jones spends under $10 a month to roll his own cigarettes with a machine. But he's taking notice of the penalty that could keep him without insurance.

"I guess it's an incentive to quit," he said. "I'd much rather be able to take care of myself, take proper meds than smoke cigarettes."




All of his ailments are associated with smoking and extra weight. If he stops smoking and loses some weight, his blood pressure, cholesterol and acid reflux should improve.


Not always true. These conditions can sometimes be ailments withOUT smoking too. I have high blood pressure and do NOT smoke. It is hereditary. I am NOT over weight either. My teen age daughter is actually under weight and has acid reflux...had it since she was an infant, she doesn't smoke either. Yes many lead unhealthy lifestyles and have medical conditions, but not ALL ailments can be controlled or prevented by losing weight or not smoking. Genetics cannot be changed.


Thank you. Some people and their arm chair doctoring.

The Bizness

This guys is fat, smokes, and probably eats like crap....I bet if he ate a good diet high in veggies and cut back on crap he would feel like a new man.


I heard the President of the Cleveland Clinic once say that 70% of health problems in the U.S. can be attributed to three things:

Obesity &
Lack of Exercise.

So, when are the central planners in DC gonna require every American to lose weight and exercise?



Agree with you on this Contango--seems to me the smokers always get picked on. If I had a nickle for all the non-smokers I know who have every ailment known (and loves to share them with anyone who has two ears) I could retire. Yet they carp, carp, carp on the smokers. Pathetic.


Yeah, promoting better health is SO communist.


PROMOTING better health? Nope, not communist at all. COERCING? BLACKMAILING? FORCING AT GUNPOINT? That's just a little different! Even under the PRETENSE of freedom, you makes your choices, and you lives (and dies) with them.

Seriously, the guy knows he's overweight and he knows smoking isn't the healthiest of habits. Okay. But now are you going to send somebody over to chain his fridge shut? To whip him as he runs on a treadmill? To disallow any Twinkies purchase he tries to make? Really? Just how invasive do you think government ought to be, eh?


Re: "promoting"

Even then, what business is it of govt. what someone eats or if they exercise?


I have no problem with publicizing the results of a study that shows smoking is bad for you and spinach is good for you. You can't make ANY kind of a decision (or you shouldn't), good or bad, without being informed. My problem comes when you're forced to make a decision, and even then your decision had darned well better be the one you're "supposed" to make!


what? no verse? Dang, I expect something witty every time I see your name on here!


I'm truly sorry if smokers get offended when people complain about them smoking. God forbid those people not want that awful smell on their clothing, or in their cars, in their lungs, or around their children. How dare they get mad that you are directly harming yourself and everyone around you? The nerve of non-smokers.

Obviously that was total sarcasm. You smokers are idiots. You smell awful, look awful, and are polluting yourself and others. You should quit and I fully support any movement that can be made to stop this awful addiction. And it is that, addiction, don't try saying habit. This addiction kills people of lung cancer every single day. WAKE UP PEOPLE. The stuff is bad for you, grow up.


Had parents that use to smoke......I hated it growing up. Everything stunk to high heaven of smoke. Plus 2nd hand smoke is horrible for you.

Some people need to make choices.......or better choices. Look around at the obesity that is killing this nation. Obesity IS a choice bottom line. Unhealthy overeating and no exercise leads to this. Some greater than others and the health complications related to Obesity will make the baby boomer generation look miniscule. Obesity leads to a whole slew of medical complications. Throw cig smoking on top of that and you are a walking, talking medical mess.