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Fact Sheet
March 2013

How Tobacco Rating Could Price Americans Out of Coverage and What States Can Do to Help

Under the Affordable Care Act, insurance companies can charge tobacco users more, a practice referred to as "tobacco rating." This practice could make health coverage unaffordable for many Americans and may disproportionately affect low-income consumers, people with less education, and people with mental illness.

Tobacco rating does not actually help people stop smoking, and it may penalize those who need access to affordable coverage the most. While people with low incomes will be eligible for financial assistance to buy coverage in the new health insurance marketplaces, this assistance won't help pay for the added cost of tobacco rating. This means tobacco users will have to pay the entire cost without help, regardless of their income.

States have the authority to create policies that will help ensure that tobacco rating does not make coverage unaffordable. Advocates should use this as a guide to help state officials and legislators understand that tobacco rating may price people out of coverage.