Health insurance companies today can legally charge smokers up to 50% more in premiums than non-smokers, based on the simple fact that smokers have made a dangerous lifestyle choice. As the latest surge in the coronavirus pandemic ravages America — especially those portions of America where misguided ideological rejection of science has spurred people to refuse the vaccine — some advocates are calling for making the willfully unvaccinated pay higher insurance rates to cover the costs they’re incurring in the health care system.

Monday’s full regulatory approval of the Pfizer vaccine strengthens that argument.

One of the important reforms under the Affordable Care Act (Obamacare) is that it prevents health insurance companies from refusing coverage or charging higher rates to people with preexisting medical conditions. But Obamacare specifically allows higher premiums for smokers. This makes sense because, unlike a preexisting medical condition, smoking is a choice — and a potentially costly one for everyone else in the insurance pool.

Resurgent coronavirus infections, led by the delta variant, are now causing a full pandemic resurgence. Infection and death rates are rising dramatically even though vaccine rejection has become a political badge of honor in certain areas. Hospital beds are filling. Alabama, a national hotbed of vaccine obstinance, is completely out of intensive care unit beds.

Almost all the new illnesses and deaths are among the unvaccinated. With vaccines now widely available and free of charge, virtually every adult who remains unvaccinated today has done so by choice.

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The only sliver of justification for the holdouts (and it is a sliver) was that the Food and Drug Administration’s approval of the vaccines was done on a fast-track emergency basis — necessary to get the vaccines out there as soon as possible. But it has had the unfortunate effect of allowing some critics to claim, falsely, that the approval process was somehow inadequate.

In any case, that argument is now moot, with the FDA’s approval of Pfizer-BioNTech’s two-dose vaccine. That and the anticipated approval of other vaccines means many universities and hospitals, along with the U.S. military, will soon require proof of vaccination for employees, students and service members. Private businesses will have a stronger case to require vaccination of employees and patrons — and red state politicians who have moved to prohibit such requirements will no longer have even the weakest of justifications.

Allowing the insurance industry to charge higher premiums for the unvaccinated would likely require changing the rules governing Obamacare, which would mean a major fight in Congress. It would be a fight worth having. The sooner society stops treating this pandemic as a culture war skirmish and starts treating it as the public health crisis it is, the better.


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