Which states don’t allow a tobacco surcharge on health premiums?

Short answer: Seven jurisdictions ban tobacco rating entirely: California, the District of Columbia, Massachusetts, New Jersey, New York, Rhode Island, and Vermont (Connecticut bans it only on its state Marketplace). Elsewhere insurers may add up to a 1.5x surcharge.

Federal ACA rules let insurers charge tobacco users up to 50% more (a 1.5:1 ratio), but states can be more restrictive. In those jurisdictions, smokers and non-smokers pay the same rate. Where the surcharge is allowed, the plan must offer a tobacco-cessation program, and completing it removes the surcharge. Tobacco is one of only four factors the ACA permits for pricing, along with age, geography, and family size.

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