Wait. How is that? I thought ACA was the opposite of that.
Before ACA, you could only be charged based on actual medical history. You could not “discriminate” based on behavior.
ACA has a specific clause allowing providers to impose a surcharge of up to 50% for smokers:
SEC. 2701 ø42 U.S.C. 300gg¿. FAIR HEALTH INSURANCE PREMIUMS.
(a) PROHIBITING DISCRIMINATORY PREMIUM RATES.—
(1) IN GENERAL.—With respect to the premium rate
charged by a health insurance issuer for health insurance coverage offered in the individual or small group market—
(A) such rate shall vary with respect to the particular
plan or coverage involved only by—
(i) whether such plan or coverage covers an individual or family;
(ii) rating area, as established in accordance with
paragraph (2);
(iii) age, except that such rate shall not vary by
more than 3 to 1 for adults (consistent with section
2707(c)); and
(iv) tobacco use, except that such rate shall not
vary by more than 1.5 to 1;