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Americans Back Higher Insurance Rates for Smokers, Not Obese

Americans Back Higher Insurance Rates for Smokers, Not Obese
by Justin McCarthy

Story Highlights

  • 59% say it's justified to charge smokers more
  • 37% say significantly overweight people should pay higher rates
  • Smokers less likely to say those who smoke should pay more

WASHINGTON, D.C. -- Many more Americans say insurers would be justified in setting higher health insurance rates for smokers (59%) than for those who are significantly overweight (37%). That gap has been evident each time Gallup has asked these questions.

insurance rates graph 1

These latest data were collected July 5-9 as part of Gallup's annual Consumption Habits poll.

Slightly fewer U.S. adults endorse higher rates for these individuals now than when Gallup first asked the question -- in 2003, 65% said higher rates for smokers would be justified and 43% felt the same about significantly overweight individuals.

Much of the decline in perceptions that higher rates for smokers are justified has been along political lines. While Republicans and independents hold similar views now to what they did in 2003, Democrats have become significantly less likely to find this justifiable -- dropping from 64% in 2003 to 55% today.

Similar to views on insurance rates for smokers, Democrats have become less likely to say higher insurance rates for the significantly overweight are justified since 2003 -- 42% then compared with 27% today. Meanwhile, there has been no meaningful change among Republicans and independents.

Smokers Less Likely to Say They Should Be Penalized With Higher Rates

Among U.S. adults who report that they have smoked cigarettes in the past week, 42% say it is justified to charge smokers higher rates for insurance, slightly higher than the average 36% across Gallup's trend. This compares with 63% of those who do not smoke.

Views on Higher Insurance Rates for Smokers, by Smoking Status
Have you, yourself, smoked any cigarettes in the past week?
Yes, smoked No, have not smoked
% %
Justified 42 63
Unjustified 57 34

Regardless of Own Weight, Few Say Higher Rates for Overweight Are Justified

Gallup asks Americans to categorize themselves as very overweight, somewhat overweight, about right, somewhat underweight or very underweight.

Fewer than four in 10 Americans who describe themselves as "overweight" or who say their weight is "about right" or "underweight" say it is unjustified to charge significantly overweight individuals more for health insurance.

Views on Higher Insurance Rates for the Significantly Overweight, by Self-Assessed Weight Situation
How would you describe your own personal weight situation right now
Overweight About right/Underweight
% %
Justified 39 35
Unjustified 59 63

Bottom Line

Americans are slightly less likely now than a decade ago to say it is justifiable to charge smokers more for health insurance, but a majority still feel such a move is appropriate.

Such policies might not benefit the overall insurance pool, however. A study by the Yale School of Public Health found a provision in the Affordable Care Act allowing insurers to set higher rates for smokers backfired. The provision ultimately discouraged many smokers from signing up for insurance and did not prompt them to quit.

Regardless, Americans support charging smokers more.

Americans' views do not extend to a similar policy for the overweight, however. Americans are either more sympathetic to those who are obese or feel obesity poses less of a threat to healthcare costs than smoking does -- although smoking is on the decline, while obesity is on the rise.

Historical data are available in Gallup Analytics.