Health insurers would be allowed to charge smokers higher rates under the Senate Finance Committee's healthcare reform bill, but no such provisions are in place for users of illicit drugs, CNS News reported Oct. 28.

Smokers have long paid higher premiums on life insurance due to higher mortality rates and shorter lifespans, and the health-reform bill applies similar logic, allowing insurers to charge smokers up to 50 percent more than nonsmokers.

However, the measure contains no such provisions for illicit drug users, such as individuals who smoke marijuana or crack cocaine.

Tobacco use, age, and family composition are the only criteria that insurers would be allowed to use to vary premiums, the bill says. "To the extent that tobacco use is known to be an unhealthy behavior and to lead to higher medical expenses on average in the future, you would definitely want individuals to be able to be charged more because if they're going to be taking more out of the health care insurance, then they should pay more," said economist Earl Grinols of Baylor University.

On the other hand, he asked, "Why are they talking about tobacco use only, not drug abusers? What about people who choose to do hang gliding and technical rock climbing without ropes? They're going to have higher medical expenses as well. To the extent that cocaine users and drug abusers also have higher costs, there's no question that it's favoring those types of medical abusers with respect to tobacco."

Allen St. Pierre, director of the National Organization for Reform of Marijuana Laws, said that tobacco was far more deadly than marijuana. "As much as other drugs are problematic, tobacco kills -- according to the (federal) CDC (Centers for Disease Control and Prevention) -- anywhere between 350,000 and 450,000 people a year. So at least from a public-health point of view, if there was going to be one single drug that people were going to interact less with, one could make the argument that tobacco would be that drug," he said.