I have written about the perils and predictable pitfalls of Obamacare before, and yet another example of the law’s asinine and unworkable structure has been revealed. One of the act’s most hyped lauded features is that it forbids insurance providers from charging more for people with pre-existing medical conditions. Stretching language to absurd, Joycean lengths, the medical exchange boards of Washington DC, California and Connecticut have decided that being a smoker is such a condition, and that smokers cannot by law be discriminated against. To cover the losses, non-smokers will be forced to make up the difference.
Mohammad N. Akhter, chair of the DC Health Benefit Exchange, stated that tobacco use is a “pre-existing medical condition” and that charging smokers more for their insurance would be “in direct conflict with our efforts to help people quit smoking.”
So there you have it. A risky and voluntary behavior—directly associated with the death of nearly a half million Americans a year—is now a medical condition. Americans should be prepared for more of this topsy-turvy nonsense as the Patient Protection Act is an absolute bureaucratic nightmare. As Nancy Pelosi famously said, Congress has “to pass the bill so [people] can find out what’s in it.” That prediction has has largely come true, though not in the way the former Speaker of the House intended. People don’t seem to be thrilled with Obamacare now that they see what a mess it will be. Three years after passing the controversial legislation, only 37% of Americans support the bill and 67% of the uninsured, the very people it was supposed to help, are unaware of how it will affect them.
This financial consideration from the government should come as a complete shock to smokers everywhere, as cigarette taxes have skyrocketed in recent years. The average state and federal tobacco excise taxes increased by 290% between 1995-2009, from $0.57 to $2.21 a pack. Obama is currently cheerleading for a further 94-cent increase.
So charging smokers more for medical insurance isn’t conducive to helping people quit, but charging them more than $3 a pack in taxes alone somehow is. Huh.
Bureaucratic weaseling like this is fraught with eminently foreseeable consequences. Kevin D. Williamson has a pretty stellar takedown at National Review:
Obamacare is designed to destroy the insurance market. Markets do not function without prices, and Obamacare ensures that prices will not be allowed to emerge. There is a medical price associated with smoking, but the District of Columbia has decided to suppress that price by law. Pretending that smoking has no relationship with health-care costs does not make it so — it is only a way to push costs around in a way that is agreeable to the likes of Barack Obama, converting a system that prices risk into a system of entitlements.
That leaves us with a system that is private in name only — which is the point.
It is meaningless to say that we have a private system in which private consumers buy insurance from private insurers when the insurers have been forbidden to price their products, and have instead been converted into something somewhere between a public utility company and a government contractor. Sure, you are free to buy any insurance you want — but if what you want is a lower rate for being a non-smoker, the point is moot, because it would be a crime for anybody to sell it to you.
Another unpleasant reality in this whole debate is how meaningless it actually is. The common conception is that smoking drives up the cost of medical care and that minimizing tobacco use would save millions or billions of dollars every year. The government is clearly torn between enacting sin taxes to punish smokers and giving them victimhood status by declaring their habit a pre-existing condition. However, it turns out that non-smokers actually cost health systems more than both smokers and the obese. Turns out that living longer and healthier is actually much more costly than dying younger.
One of the biggest problems with Obamacare is that it creates incredibly perverse incentives to interfere with the lives of adults. When people are forced to pay for others, they feel entitled to control behavior that may affect their tab. The rationale goes like this: Smoking is dangerous and seemingly costs money; therefore it’s an activity that needs to be controlled. The same reasoning justifies paternalistic efforts to curb obesity, leading to bans on sodas over 16 ounces and trans fats in Michael Bloomberg’s New York. Everyone should be terrified of following this rabbit hole towards its logical conclusion, where politicians can arbitrarily create laws to control seemingly any activity.
As dysfunctional as our current health care system is, Obamacare is the wrong prescription for change. It doubles down on bureaucracy and further diminishes individual choice. Barring repeal and a true injection of market forces, Americans should brace themselves for more schizophrenic and intrusive measures like this, where the government wants to both subsidize and tax the same activity, and the healthy are forced to pay for the lifestyles of the reckless.