MAHA Can Help Save Medicaid IMMEDIATELY

WASHINGTON - May 14, 2025 - PRLog -- While many Americans are fearing major cuts under Medicaid, a MAHA technique developed and advocated in the 1980s by the National Association of Insurance Commissioners [NAIC], and utilized many times since then - including under Obamacare - could slash the costs of medical care under Medicaid simply by imposing personal responsibility, suggests public interest law professor John Banzhaf.

Instead of broadly slashing Medicaid benefits across the board, imposing personal responsibility upon those who balloon the costs of medical services by continuing to smoke - by making them pay for the huge medical costs they now impose on others - would largely solve much of the problem, says Banzhaf, who helped persuade Congress to adopt a 50% surcharge on smokers under Obamacare.

Although fewer than 12% of U.S. adults still smoke, cigarette smoking cost the United States more than $600 billion in 2018, including more than $240 billion in healthcare spending.  A whooping 21.5% of that was imposed upon Medicaid.

So if the majority of smokers who now impose the cost of their totally unnecessary habit on the majority of taxpayers were to quit, the program and taxpayers would save over $50 billion a year in Medicaid health care costs; more than half of the $88 billion annual cuts in Medicaid spending now being sought.

One way to do this - as recommended by the NAIC - would be to require smokers to pay the excess costs their habit now unnecessarily imposes in order to have health insurance coverage; just as smokers have always been required to pay more than nonsmokers for life insurance.

A typical 2-pack-a-day smoker now spends over $7000 a year to smoke, while imposing the huge medical care costs on others though various programs, including Medicaid.

Asking them to accept personal responsibility for their own unhealthy health care choices by paying all or most of that in order to remain on Medicaid would pressure some of them to quit; while those who choose to remain smokers would be paying their fair share of the costs, Banzhaf adds.

It is estimated that, under the Medicaid reform proposed by the House Republicans, more than 8.5 million Americans will become uninsured; a number which includes many who are powerless to do anything about it.

So, while forcing smokers to pay even a fair share of the huge health costs they currently impose on others through Medicaid might persuade many of them to leave the plan, this is less unfair since they - unlike many of the others who will probably be dropped - can avoid this simply by giving up smoking; as tens of millions of former smokers have, argues Banzhaf.

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