Should insurers treat e-cigarettes like traditional tobacco products?


As e-cigarettes quickly gain popularity--more than 20 million people tried smoking one sometime in 2013--insurers are left without guidance or precedence on how to determine whether they should raise premiums for members who smoke e-cigarettes, reported the St. Louis Post-Dispatch.

The Affordable Care Act states insurers can add as much as 50 percent to tobacco users' premiums, but it doesn't mention anything about e-cigarettes, which weren't commonly used back in 2010, FierceHealthPayer previously reported.

Without federal guidance, insurers can decide whether they consider e-cigarettes, which contain no tar and less nicotine than traditional cigarettes, to be in the same category as traditional tobacco products.

"There's a little bit of a regulatory vacuum here that I think could allow an insurance company to kind of decide for itself how to approach this issue," Sabrina Corlette, an attorney and professor at Georgetown University's Center on Health Insurance Reforms, told the Post-Dispatch. "This is one of these areas where the industry is ahead of the regulators on this one."

But since the ACA was passed four years ago, the Centers for Disease Control and Prevention found that e-cigarette use has more than doubled, with about 8 percent of all adults trying the electronic device at least once. What's more, frequent e-cigarette use has grown from 1 percent of adults in 2010 to 2.6 percent last year.

The problem for payers, though, is that this growing trend may actually be detrimental to their bottom lines and could even undermine their attempts to motivate members into reducing their smoking habits.

Currently, many insurers aren't treating e-cigarettes like traditional cigarettes or tobacco products. Coventry, for example, doesn't ask about enrollees' e-cigarette usage, though the insurer will revisit that policy based on future federal guidance.

"For our individual business we do not consider e-cigarettes as tobacco use that can affect the rates we charge," Deb Wiethop, a spokeswoman for Anthem Blue Cross Blue Shield in Missouri, told the Post-Dispatch. "We interpret tobacco as products that contain tobacco such as cigarettes, cigars, chewing tobacco and snuff."

To learn more:
- read the St. Louis Post-Dispatch article

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