Last reviewed June 2026

Are there limits on charging tobacco users more?

Short answer: Yes. Federally the surcharge is capped at 1.5x premium, and seven jurisdictions (six states and DC) ban it entirely. Where it’s allowed, the plan must offer a cessation program that removes the surcharge.

The ACA limits any tobacco surcharge to a 1.5:1 ratio (50% more than a non-user), and it’s one of only four permitted rating factors. States can be stricter: California, DC, Massachusetts, New Jersey, New York, Rhode Island, and Vermont prohibit tobacco rating outright (Connecticut bans it on its Marketplace). Where a surcharge applies, the insurer must offer a tobacco-cessation program, and completing it lets the member avoid or recover the surcharge.

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