[davidf18]

A major problem is that Congress mandated the medical ration between young adults and the elderly to be 1:3 instead of 1:6 which better reflects the true costs of care meaning the young would be paying 75% more than they should for their age category. Many have complained that young, healthy people are not signing up for health plans but this is the reason why. The youth are paying 75% more than they should in an efficient market. Fix the medical ratio to be 1:6 and there will probably be a lot more healthy young people signing up for insurance.

Much of the health care costs of the elderly are from chronic disease which itself is from smoking and obesity among other causes.

Other countries such as the UK, France, and Canada have tobacco taxes at least $5 to $7 per pack. The high cost of tobacco has more than half the effect to help people to quit and helps to ensure the young never start smoking. The tobacco taxes can also be used to pay for the higher health care costs that smokers have thus helping to reduce the subsidy in health care that non-smokers pays for smokers.

When the ACA was put into place, they should have raised the Federal tobacco tax to be $5 to $7 per pack (today it is about $1).

[bubinubn]

Although there are plenty of studies to suggest otherwise, at least one study: http://journals.plos.org/plosmedicine/article?id=10.1371/jou... suggests that smokers have a lifetime healthcare cost that is lower for the simple reason that they die earlier, and dying is cheap.

full disclosure: I smoke, and am thus not impartial when it comes to higher cigarette taxes.

[davidf18]

Very sorry you're a smoker. Even if one is a smoker, one should want tobacco taxes to increase because 1) it is the single best intervention to help others to quit and for youth to never start and 2) today there are negative externalities for government (employees, Medicaid, Medicare, VA, Army) and firms that hire smokers because the health insurance costs are higher than normal. That means tax money that should be going towards other things are going towards tobacco related healthcare Instead. Taxing tobacco ensures that there is not so much of a subsidy of non-smokers for smokers.

Whether overall there is health savings for smokers, while the smokers are being covered by insurance they cost substantially more money than non-smokers.