Should Smokers Pay More For Health Care?

Inside Higher Ed had a story this week on Pennsylvania State University’s health care plan and the practices that have had some of the employees claiming too much intrusion. 

First employees were required to take an online biometric screening that includes a “full lipid profile,” body mass index and waist circumference measurement. Then they were required to pay an extra $100 premium if they had a spouse or domestic partner who had insurance through their own company. Now they are requiring anyone who smokes to pay an extra $75 a month.

According to the story in Inside Higher Ed, a “user” is defined as “anyone who has used tobacco more than five times in the three previous months, including cigars, cigarettes, chewing tobacco, pipe tobacco or any other tobacco product.”

While the employees are crying intrusion, Penn State human resource officials claim that the reason is to keep the employees as healthy as possible. The purpose of the $75 monthly cost is encouragement for those people to quit. Similarly, the $100 surcharge for employees who have access to another plan through a spouse or domestic partner was billed as a “financial encouragement” to do so. 

While these practices are billed as incentives, others see them as penalties. Under the Affordable Care Act, these type of incentives, or penalties as the case may be, are likely to continue since the Act raises the maximum levels of differential contribution based on participation in wellness programs. According to Inside Higher Ed, they are now capped at 30 percent, up from 20 percent, except for smoke use, which is now at 50 percent. 

What do you think? Is it fair to charge smokers an extra premium for health insurance? Or is this a slippery slope that will just continue to get more and more intrusive?