“Smokers Should Pay More”

Federal employees who smoke should pay more in health insurance premiums than non-smokers according to our latest poll.

In recent years, smokers in the federal workplace may have felt beseiged. No longer can smokers light up during staff meetings. Bathrooms and private offices are also generally off-limits to a federal employee yearning for a cigarette.

Walking along the sidewalk outside of federal buildings, a casual observer is likely to see groupings of employees standing or sitting outside and enjoying the thrill of a cigarette before going back in to work.

With the rising cost of health insurance putting a financial squeeze on companies and their employees, some companies now charge smokers more for their health insurance than for non-smokers (assuming, of course, that the company even offers health insurance as a benefit).

And, while the federal government has an active no-smoking policy in its buildings, there is no distinction between the health insurance rates paid by those who smoke and those who do not smoke. In our latest poll, we asked the question:

"Should health insurance premiums under the federal employee health insurance program be higher for smokers than for non-smokers?"

Here is a quick summary of the results.

  • 61% said health insurance premiums should be higher for smokers
  • 35% said health insurance premiums should not be higher
  • 3% were undecided
  • 1% checked "other" as their answer
  • The subject of smoking sometimes elicits an emotional response. Not surprisingly, combining an issue that is sometimes controversial with the subject of money and there is likely to elicit strong feelings on all sides of an issue. That is certainly the case with the issue of smoking and health insurance.

    There were hundreds of responses. As you can see from the overall results above, the poll results were definitive. But many readers explained the nuances of their views in more detail.

    The most typical response was that it was unfair to single out smokers for paying higher insurance rates without also charging more for other employees with "bad habits" or situations that would impact their probable health issues.

    Here is a sampling of the comments.

    Self-interest admittedly plays a role in the views of many readers. A management analyst with the Dept. of Justice in Washington said: "There should be a surcharge for people who drink and people who are grossly overweight as well. All three of those categories have significantly higher medical expenses. Needless to say, I don’t fall into any of those categories and I would appreciate the lower insurance costs."

    A secretary from the VA in Hampton, VA wrote: "I would love to say ‘Yes’ and perhaps have lower premiums, but I don’t see it as reasonable. What about people who are overweight, drink alcohol or drive too fast. Where would it end? All of these circumstances could result in an increased use of medical services. What about diabetics or people with Rheumatoid Arthritis? Once we start on that road, there is nowhere to turn around. "

    A director of the Environmental Protection Agency in Washington said: "Where do we draw the line? What group would be singled out next? Where is our sense of compassion and community?"

    An SSA manager from Chicago had this to say: "I’m not a smoker, so it is moot for me. But health insurance is a risk pool. Should older or sicker people pay more because they need more meds? Should you have to pay more for not eating your veggies? How about if you drive while talking on a cell phone (higher accident rate = higher medical costs.) It is time to stop "big mother" government."

    A revenue agent from the IRS in San Bernadino, CA had this to say: "Obesity should also be a factor in determining premiums. There is no reason that those of us who take care of our bodies should be subsidizing those who blatantly abuse theirs. If I get in a car accident or get tickets, my rates go up because I am a higher risk. No one is required to subsidize the bad driving habits of others. By the same token, we should not be expected to pay for bad health habits of others."

    An administrative assistant from GSA in Philadelphia viewed the situation with this self-interest in mind: "No, because if they start charging smokers, next they’ll start charging seniors, or retirees more."

    A program analyst from the VA in Murfreesboro, TN commented: "We should not start basing health insurance premiums on the employees’ health or activities. If it were to start with whether or not one smokes, it could eventually escalate to basing rates on pre-existing conditions. If someone has AIDS, or diabetes, or cancer, should they pay more premiums?"

    A human resources specialist from the Dept. of Transportation in Washington also thought charging smokers more was not a good option but saw other options that should be considered in determining health insurance premiums: "Though I am aware that smokers tend to have more health issues so do overweight people, individuals with asthma, persons with certain disabilities, older workers…. There are a number of different medical issues that could and will arise that is why we have group insurance. Now I wouldn’t mind a change that would involve paying by the household member nor would I object to the establishment of a separate category (paying a higher premium) that would permit Feds to cover dependent parents."

    A finance specialist from Washington thought the health insurance premium differential would even out without charging smokers more money for their health insurance: "Smokers won’t live as long. There is very little research money going into ‘smokers’ diseases. It will even out in the long run."
    But not everyone thought that charging smokers more was a bad idea. Many readers think that charging higher insurance rates for smokers is a good approach. Here are some of the comments from readers with this perspective.

    An IT specialist with the Bureau of Reclamation in Denver said: "I don’t think the rest of us should have to continue supporting the poor health of smokers."

    A forestry technician from Camino, CA would approach the issue a little differently: "Smokers should not pay more, but non-smokers should get discounts and incentives."

    A claims representative from the Social Security Administration in Iowa commented: "I think it’s unfair that nonsmokers health insurance premiums keep going up because of the choice of others to not live a healthy lifestyle. If they chose to smoke and risk their health, then they also are making the choice to pay more for their health care. It only makes sense!!"

    A supervisory operations leader from the Forest Service in Chatsworth, GA wrote: "Maybe the higher health insurance costs would spur more smokers to finally quit. Non-smokers should not have to pay for smokers’ higher medical costs by way of increased insurance premiums."

    An accountant with GSA in Ft. Worth, TX expressed this sentiment: "Hell Yea! Raise the cost for smokers….I am tired of having the smell the smoke when trying to get into the building. It is hazardous to my health as a non-smoker. I am all about trying to get people to stop smoking."

    A program analyst from GSA in Ft. Worth had this to say: "Why should my premiums keep on going up to cover smoker’s health care costs?!?!?! The smoker’s are also poisoning the rest of us with their second hand smoke. I, for one, am sick and tired of smelling the horrible stench of their clothes and breaths! I think it is wonderful that cities are banning it from public places."

    A program manager with the Air Force in Manchester, TN apparently has strong feelings on the issue: "ABSOLUTELY pay extra premium !!!!!!!!!!"

    An employee of the Rural Development Agency in Craig, CO commented: "Absolutely! It is proven that a smoker’s health is in direct relation to their habit, generally speaking. And if they are not in poor health now, they will be eventually. Had they not smoked, the chances are overwhelmingly that they would be in better health, have fewer visits to the doctor’s office/ER and have less claims against their/my insurance. For those that use more insurance, especially for such an identifiable risk, they should pay more."

    An attorney with the VA in Philadelphia explained his views this way: "As federal employees we are blessed with good, relatively inexpensive health benefits – but they still take a bite out of our take-home pay! A much lower premium could be charged if those who engage in self-abuse are insured separately. I believe I have a responsibility to help those who have bad luck. I feel no such responsibility towards those with bad behavior. "

    This reader may have checked "other" in the survey as reflecting his or her views of the matter. A systems analyst with the Nuclear Regulatory Commission in Washington explained: "If it comes down to everybody paying more or just the smokers, than I agree the smokers should pay more. If non-smoker’s premiums will be the same regardless of whether smokers pay more or not, then I say no. Bottom Line: Yes, if it will keep non-smoker’s premiums lower; No, if it won’t make a difference in non-smoker’s premiums."

    And an editor with the Forest Service in Marienville, PA did not like the wording of the introductory article for the survey: "I feel so strongly about this issue that I took note that your article says that smokers "face more discrimination than ever." I object to your word choice. Smoking is not a right and smokers are not part of any protected group. Limitations yes, discrimination no. Calling it discrimination does a disservice to those who have experienced discrimination in the true sense of the word."

    An analyst from the State Department thinks it is a lifestyle choice and smokers should pay for their choices: "While smoking is an addiction, it is one that adversely affects the health other people through second-hand smoke. Unlike many other addicts, any smoker can quit without suffering serious physiological side-effects if he/she makes a serious commitment to doing so. We need to stop subsidizing the health costs of bad habits such as smoking and obesity induced by over-eating."

    And, finally, here is a comment from a budget analyst with the Department of the Army at Ft. Stewart, GA: "As a former smoker (now quit for over 2 years), I can attest to the fact that I spent a whole lot more time in the ER and as an in-patient when I smoked than now. I know I cost my insurance company a lot more money in claims (tens or thousands of dollars in a year, typically) than I do now. And it was a hefty price I paid as well, not just monetarily, but mentally and emotionally. After the last time I was hospitalized and almost died from a severe asthma attack worsened by my nasty habit, I quit for good. The cost was just too great all the way around. However, I still think about it and want to from time to time, I just choose not to. The consequences just aren’t worth the mometary pleasure."

    Our thanks to the readers who took the time to vote in our recent survey and a special thanks to those to sent in their opinions on the issue.

    About the Author

    Ralph Smith has several decades of experience working with federal human resources issues. He has written extensively on a full range of human resources topics in books and newsletters and is a co-founder of two companies and several newsletters on federal human resources. Follow Ralph on Twitter: @RalphSmith47