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This is a Quantitative Study study.

Rate-Making, Smoker Surcharge, and Insurer Risk Management Under the U.S. Affordable Care Act

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Conceptual investigation explores tobacco surcharge implications for health insurance premiums, suggesting flexibility for insurers.

Insurers can apply tobacco surcharges creatively, impacting insurance premiums in various markets, including non-group and small group.
The study shows insurers can charge up to 50% more in premiums for smokers compared to non-smokers, reflecting risk management strategies.
Utilizing the CMS age curve and insurer rating schedules, the research illustrates potential pricing structures and their implications.
This approach highlights the regulatory flexibility insurers have under the ACA, raising questions about equity and access for smokers.

Roger Lee Mendoza (2025) studied this question.

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