TobaccoSurchargeson2015HealthInsurancePlansSold inFederallyFacilitatedMarketplaces:VariationsbyAge andGeographyandImplicationsforHealthEquity

In 2014, few health insurance plans sold in the AffordableCareAct’sFederally FacilitatedMarketplaceshad age-dependent tobacco surcharges, possibly because of a system glitch. The 2015 tobacco surcharges show wide variation, with more plansimplementingtobacco surcharges that increase with age. This underscores concernsthatoldertobaccousers will find postsubsidy health insurance premiums difficult to afford. Future monitoring of enrollment will determine whether tobacco surcharges cause adverse selection by dissuading tobacco users, particularly older users, from buyinghealthinsurance.(Am