Viewpoint |

Smoking, Obesity, Health Insurance, and Health Incentives in the Affordable Care Act

Kristin Madison, PhD, JD1; Harald Schmidt, PhD2; Kevin G. Volpp, MD, PhD3,4
[+] Author Affiliations
1School of Law and Bouvé College of Health Sciences, Northeastern University, Boston, Massachusetts
2Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia
3Center for Health Equity Research and Promotion, Philadelphia VA Medical Center, Philadelphia, Pennsylvania
4Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
JAMA. 2013;310(2):143-144. doi:10.1001/jama.2013.7617.
Text Size: A A A
Published online


One fundamental reform of the Patient Protection and Affordable Care Act (ACA) was to weaken the link between health status and insurance coverage. Issuers of individual policies will no longer be able to charge higher premiums to the seriously ill or turn away unhealthy enrollees. By adding these protections, the ACA brings individual policies more in line with other forms of insurance. Neither Medicare nor Medicaid charges higher premiums for individuals in poor health, and the Health Insurance Portability and Accountability Act of 1996 (HIPAA) prohibits group health plans from conditioning employee eligibility or premiums on health status–related factors such as cancer, heart disease, or diabetes.1

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview




Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 2

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

See Also...
Articles Related By Topic
Related Topics
PubMed Articles