Surcharge for smokers on Medicaid

Bill seeks surcharge for Utah smokers on Medicaid

By Brian Passey, USA TODAY

ST. GEORGE, Utah – If private health insurers can add a surcharge for smokers, why not Medicaid?

  • By Victor R. Caivano, AP

    Utah Republican Rep. Paul Ray is proposing that the state impose a higher co-pay on Medicaid residents who use tobacco.

By Victor R. Caivano, AP

Utah Republican Rep. Paul Ray is proposing that the state impose a higher co-pay on Medicaid residents who use tobacco.

That’s the argument behind a bill Utah Republican Rep. Paul Ray has proposed that could become a first-in-the-nation state law imposing a higher co-payment for tobacco-using residents enrolled in Medicaid.

Although Medicaid recipients in Utah do not pay premiums, some are required to pay up to $5 co-payments for prescriptions or doctor visits.

According to the American Lung Association, smokers enrolled in Medicaid smoke at a rate 60% greater than the general population. Ray said smokers on Medicaid cost Utah $104 million annually. “If they’re paying $7 a day for a pack of cigarettes, they should be able to pay a $2 to $3 co-pay,” Ray said.

Ray said he believes his proposal is unique among state Medicaid programs. Alper Ozinal, a spokesman from the Centers for Medicare & Medicaid Programs, said his agency is not aware of other states that have considered similar legislation

Robert Zirkelbach, a spokesman for America’s Health Insurance Plans, a health industry trade association, said many health insurance providers have chosen to implement surcharges on smokers because of the broad recognition that smoking increases health complications and resulting health care costs.

The American Lung Association opposes the proposed co-payment. There is no evidence that it would encourage smokers to quit, said Jennifer Singleterry, the association’s manager of cessation policy. Instead, low-income smokers on Medicaid would just have to pay more. “We feel that this is a punitive measure for smokers,” she said.

Gary Nolan, U.S. director for the Citizens Freedom Alliance, a property rights and smoker advocacy organization that also opposes the proposed law, added that legislation that affects smokers is easy to pass because smokers do not represent a large voting demographic.

The bill went before the Utah House Government Operations Committee on Thursday. It is being modified to include a wellness aspect with a smoking cessation program. Ray said he plans to bring it back before the committee next week. He said he does not expect much opposition within the heavily Republican House and Senate.

Ray said he would like to eventually extend the idea to an entire wellness program that would include obesity and alcohol use.

“I’m not trying to do this to punish people,” he said. “I’m doing this to encourage people to be healthy.”

Contributing: Passey also reports for The Spectrum in St. George, Utah