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Poll: Majority Favors Charging Smokers Higher Insurance Rates, But Not Overweight People

Fifty-eight percent of Americans surveyed favor charging smokers higher insurance rates, but only 41 percent would charge overweight people more, according to a Gallup poll released Monday.

Under the Affordable Care Act, states have the option of allowing health plans participating in online insurance marketplaces to charge smokers up to 50 percent higher premiums than non-smokers. This provision, however, is not required, and some states and the District of Columbia are choosing to not charge more. In addition, California, Massachusetts, New Jersey, New York, Rhode Island, Vermont and D.C. have declared they will not charge smokers higher premiums, according to the Department of Health and Human Services. There is no provision in the ACA for charging overweight individuals more.

Attitudes toward smokers have changed little since 2003, when 65 percent said a higher rate is justifiable because of higher health costs. Smokers, not surprisingly, are less likely to agree with being charged more, the new poll found. Of those who had smoked cigarettes within a week of being surveyed, only 28 percent think higher rates are a good idea, while 65 percent of non-smokers support  higher premiums.

Consumer advocates are skeptical that charging smokers more for health insurance will discourage them from smoking. Some think the higher rates will cause smokers to drop their coverage altogether and some state officials see this option as a form of discrimination, akin to pricing health insurance differently based on gender or medical conditions.

The poll, part of the annual Consumption Habits survey, surveyed 2,027 adults in all 50 states and D.C. from July 10-14 and has a margin of error of +/- 3 percentage points.