title: Tobacco Surcharges on 2015 Health Insurance Plans Sold in Federally Facilitated Marketplaces: Variations by Age and Geography and Implications for Health Equity.
abstract: In 2014, few health insurance plans sold in the Affordable Care Act's Federally Facilitated Marketplaces had age-dependent tobacco surcharges, possibly because of a system glitch. The 2015 tobacco surcharges show wide variation, with more plans implementing tobacco surcharges that increase with age. This underscores concerns that older tobacco users 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 buying health insurance.
authors.affiliation: Alex C. Liber and Jeffrey M. Drope are with Economic and Health Policy Research, Intramural Research Department, American Cancer Society, Atlanta, GA. Ilana Graetz, Teresa M. Waters, and Cameron M. Kaplan are with the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis.
authors.forename: Alex C
authors.initials: AC
authors.lastname: Liber
authors.affiliation: Alex C. Liber and Jeffrey M. Drope are with Economic and Health Policy Research, Intramural Research Department, American Cancer Society, Atlanta, GA. Ilana Graetz, Teresa M. Waters, and Cameron M. Kaplan are with the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis.
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Drope
authors.affiliation: Alex C. Liber and Jeffrey M. Drope are with Economic and Health Policy Research, Intramural Research Department, American Cancer Society, Atlanta, GA. Ilana Graetz, Teresa M. Waters, and Cameron M. Kaplan are with the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis.
authors.forename: Ilana
authors.initials: I
authors.lastname: Graetz
authors.affiliation: Alex C. Liber and Jeffrey M. Drope are with Economic and Health Policy Research, Intramural Research Department, American Cancer Society, Atlanta, GA. Ilana Graetz, Teresa M. Waters, and Cameron M. Kaplan are with the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis.
authors.forename: Teresa M
authors.initials: TM
authors.lastname: Waters
authors.affiliation: Alex C. Liber and Jeffrey M. Drope are with Economic and Health Policy Research, Intramural Research Department, American Cancer Society, Atlanta, GA. Ilana Graetz, Teresa M. Waters, and Cameron M. Kaplan are with the Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis.
authors.forename: Cameron M
authors.initials: CM
authors.lastname: Kaplan
mesh_terms: D000328:Adult; D005249:Fees and Charges / Q000706:statistics & numerical data*; D062265:Health Insurance Exchanges / Q000191:economics* / Q000706:statistics & numerical data*; D006801:Humans; D007348:Insurance, Health; D008875:Middle Aged; D058991:Patient Protection and Affordable Care Act / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D062789:Tobacco Products / Q000706:statistics & numerical data*; D014481:United States