Report on Tobacco Use Rating for Health Insurance Policies


During the 2013 Legislative Session, the Maryland General Assembly passed House Bill 228 (Chapter 159, Acts of 2013), entitled the Maryland Health Progress Act of 2013. Section 6 of Chapter 159 requires the Maryland Health Benefit Exchange (MHBE) and the Maryland Insurance Administration (MIA) to conduct a joint study of the impact of the Affordable Care Act’s allowance of a tobacco use rating of 1.5 to 1, including (1) its effect on insurance premiums generally; (2) its effect on the affordability and purchase of insurance, and access to health care, for tobacco users; and (3) any disparate impact on specific vulnerable populations. The study must further assess the options that may be available to the state to address any adverse consequences of tobacco use rating.


Hilltop worked with the MHBE and the MIA to conduct this legislatively mandated study. This report contains the findings of the study and concludes with options for further legislative action.

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