Smokers and the New Health Care System

The ACA will be expensive for smokers. Under a provision of the federal health care law, states can allow health plans to charge tobacco users up to 50 percent more for their health insurance premiums. The provision allowing for a “tobacco surcharge” was designed in part to encourage smokers to quit. But critics say the smoker’s surcharge is discriminatory, which goes against the spirit of The ACA. A low-income person buying a $6,000 policy who qualified for a subsidy might see the price of the policy drop to $3,000, but the tobacco surcharge would knock it back up to $6,000 again.
The Center for Disease Control puts the nation’s annual price tag for smoking at more than $190 billion in medical care and lost productivity. Nearly 20% of people in the United States still smoke.

No Pre-Existing Conditions from birth to age 19

No pre-existing condition limits from birth to age 19

Do you have a child under 19 years old? He or she can’t be denied health care coverage because of a “pre-existing condition”. A pre-existing condition is a health problem that was discovered or treated before applying for the coverage. This applies whether your child was covered under a different plan or had no coverage at all.

Here’s what’s different

In the past, health plans could limit or deny benefits or coverage for children because of a pre-existing condition.

How it impacts you

Now your health plan can’t deny your child’s coverage because of a health problem or disability that developed before you applied for coverage.

My 13-year old daughter was hospitalized with asthma recently. My health plan denied payment for the hospitalization. They said that, under our policy, my daughter’s asthma is considered a pre-existing condition. Is that right?

No. Under the new law, the health plan can’t deny payment for the hospitalization based on your daughter’s pre-existing asthma condition.

Does this law apply whether or not my child already had coverage?

Yes. Under any circumstance, your health plan can’t deny coverage for your child based on a pre-existing condition.

Does the law apply to an individual health policy I bought for my family in 2011?

Yes. However, it does not apply to grandfathered individual health policies bought before March 23, 2010.

What can I do if my plan tries to deny coverage because of a pre-existing condition?

Under the Affordable Care Act, you have the right to appeal.

I am 30 years old. Does this law apply to me?

No, not yet. But in 2014, this protection will be extended to Americans of all ages.


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