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Public health groups and tobacco companies are united in their opposition to a provision of the Affordable Care Act (ACA) that allows insurance companies to charge smokers 50 percent more than nonsmokers, The Washington Post reports.

Groups such as the American Cancer Society say the high cost could make health insurance too expensive for smokers, who are disproportionately low income. Tobacco companies object to the provision because they say it discriminates against smokers, the article notes.

“We’re anti-smoking, not anti-smoker,” David Woodmansee of the American Cancer Society told the newspaper.

Tobacco companies and public health groups may have success in fighting the provision on the state level. States can bar health insurance companies from considering tobacco use when they set rates.

Under the ACA, starting in 2014 health insurance companies will no longer be able to charge higher premiums for patients who are expected to have higher health costs. However, the law does allow insurers to charge smokers up to a 50 percent surcharge on premiums.

An analysis by the Institute for Health Policy Solutions estimated as a result of the surcharge, a low-income person’s premium could increase from $708 to $3,308.

Most health insurance companies support the provision. The Blue Cross Blue Shield Association said if insurers are not allowed to adjust rates for tobacco use, they will have to raise rates for everyone.


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