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Final Insurance Market Reform Rule Better Defines Tobacco Rating Qualifications; More Guidance Necessary for Consumers

February 22, 2013

WASHINGTON, D.C. – February 22, 2013 – The Department of Health and Human Services (HHS) today released the final Health Insurance Market Reform Rule of the Affordable Care Act, including a more specific definition of what constitutes a tobacco user for purposes of determining whether insurers can charge a higher insurance premium. ACS CAN’s original comments on the insurance market reforms proposal called out the importance of establishing a clear definition of who constitutes a tobacco user to minimize confusion among consumers when they apply for insurance.

A statement from Christopher Hansen, president of the American Cancer Society Cancer Action Network (ACS CAN) follows:

“The final rule makes progress in defining what constitutes tobacco use, but further guidance will be essential to minimize confusion for consumers applying for health coverage. The rule defines regular tobacco use as an average of four or more times per week within no longer than the past six months, but leaves vague the definition of what constitutes a tobacco product.
“The rule further clarifies that insurers cannot rescind policies and can only charge retroactive premium penalties for the current plan year if an individual does not accurately reflect their use of tobacco. ACS CAN filed comments with the administration, expressing concern that rescinding coverage or erecting a financial barrier so steep as to make coverage unaffordable would undermine the intent of the law to provide meaningful, affordable health coverage.

“States have the option to reduce the surcharge for tobacco use or eliminate it altogether. ACS CAN will continue to urge states to forego the tobacco use surcharge, as there is little scientific evidence or research showing that financial incentives or disincentives tied to health insurance premiums will compel an individual to quit. Evidence shows state tobacco control efforts, such as smoke-free laws, taxes on tobacco products and fully funded prevention and cessation programs are proven to reduce tobacco consumption.

“ACS CAN and the American Cancer Society have always been anti-smoking, but never anti-smoker.
Tobacco addiction is a serious, chronic disease. By getting tobacco users into the health care system, they will have access to cessation services that are critical to helping them give up a deadly habit. Levying a surcharge on tobacco users could make health insurance unaffordable and prohibit them from getting either the medical help needed to break their addiction or the basic health care that we all need.”
For a full copy of ACS CAN’s insurance market reform comments, visit:

ACS CAN, the nonprofit, nonpartisan advocacy affiliate of the American Cancer Society, supports evidence-based policy and legislative solutions designed to eliminate cancer as a major health problem. ACS CAN works to encourage elected officials and candidates to make cancer a top national priority. ACS CAN gives ordinary people extraordinary power to fight cancer with the training and tools they need to make their voices heard. For more information, visit

Alissa Crispino or Lauren Walens
American Cancer Society Cancer Action Network
Phone: (202) 661-5772 or (202) 661-5763
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