2009-10-09 18:45:27 - Almost a dozen states, many in the deep south where tobacco is a major crop, are requiring smokers to pay more for the health insurance as a way of saving money as well as reducing overall health care costs, says professor John Banzhaf of Action on Smoking and Health (ASH), which has proposed that federal health reform legislation adopt similar requirements for the same reasons, as well as basic fairness to nonsmokers who now are forced to pay more than they should.

North Carolina just became at least the tenth state to shift some of the medical costs of smoking from nonsmokers to the smokers themselves, injecting some personal responsibility into their programs, says Banzhaf, noting that more and more private insurance companies are doing the same.

North Carolina estimates that it will save about $13 million a year from a program which covers about 660,000 employees and simply requires smokers to pay 30% of health care claims, rather than the 20% paid by nonsmokers. "Imagine the cost savings if the same plan were used on a national basis," suggests Banzhaf.

Better yet, says Prof. Banzhaf, why not charge smokers a higher health insurance premium to help cover a small part of the almost

$200 billion their choice to smoke imposes annually on the economy, most of which is now paid by nonsmokers in the form of much higher taxes to cover those medical costs under Medicare, Medicaid, and other government programs, as well as in inflated premiums for health insurance coverage for themselves and their families.

As MSNBC recently reported: “ 'If you talk about costs, there’s something here and now that you can do,' said John F. Banzhaf, director of the anti-smoking agency Action on Smoking and Health, which has pressured members of Congress to enact a $60 a month user fee to make smokers pay part of the health insurance costs of their habit. 'If you don’t have a user fee on smokers, that forces everyone else to pay those health care costs,' said Banzhaf, who is also a professor of public interest law at George Washington University Law School. 'One argument is that it’s simple fairness��

Prof. Banzhaf notes that there is strong objection to virtually all of the plans Congress now has to raise taxes to pay for health insurance report, including:
* Reducing funding for Medicare, especially Medicare Advantage, which would impact senior citizens
* Taxing comprehensive health insurance plans, which would hurt many union workers, first responders, and others in hazardous occupations
* Taxing high-income individuals, which might slow economic progress and recovery

He notes that even more money than any of these plans now provide could be obtained by imposing a modest surcharge on insurance premiums paid by nonsmokers -- one which still requires them to contribute much less than the costs they impose on the economy. They clearly can afford it, he says, noting that smokers pay about $90 billion each year just to fuel their habit.

A surcharge on insurance premiums paid by smokers isn't a tax but rather is in the nature of a surcharge on those who chose to continue smoking. It is one of the few funding proposals which the public supports, the only one which actually reduces health care costs rather than simply saving money, and the only one which anyone can opt-out of simply by quitting smoking, even if it means moving to a nicotine patch or gum.

The following states impose a smoker surcharge or otherwise treat smokers differently:
* West Virginia first included such a feature in part several years ago.
* Kentucky in late 2004 created a smoker surcharge of $15/month for individuals and $30/month for family coverage.
* Alabama in December 2004 authorized a smoker surcharge which is now $22/month.
* In Georgia, more than 54,000 people covered by the insurance plan for state employees are paying an extra $40 per month because they smoke or use tobacco.
* Indiana added a non-smoker rate incentive in 2006. For 2007, nonsmokers save up to $500 /year on annual deductibles.
* Kansas has a smoker surcharge authorized in 2008.
* Missouri law generally provides that public and private employers may provide health insurance at a reduced premium rate and reduced deductible level for employees who do not smoke or use tobacco products.
* South Carlina imposes a $25 monthly surcharge for state public employees and their family members who smoke or chew tobacco, effective 2010.
* South Dakota has a smoker surcharge authorized in 2008.
* In North Carolina, smokers pay 30% of claims, whereas nonsmokers pay only 20%.

PROFESSOR JOHN F. BANZHAF III
Executive Director and Chief Counsel
Action on Smoking and Health (ASH)
America's First Antismoking Organization
2013 H Street, NW
Washington, DC 20006, USA
(202) 659-4310 ** ash.org