Three Proven Solutions to the ACA Supplement Standoff

WASHINGTON - Dec. 1, 2025 - PRLog -- While Congress debates whether to continue to force taxpayers to pay for Affordable Care Act [ACA] subsidies expiring at the end of the year - which the nonpartisan Congressional Budget Office estimates would cost taxpayers about $350 billion over 10 years ($35 billion/year) - or to let them expire, all seemingly agree that medical care costs are far too high, but nothing now being considered would reduce the cost.

But there are at least three tested and proven approaches which would slash medical care costs rather than just trying to shift them, notes public interest law professor John Banzhaf, whose actions in getting antismoking warning messages on radio and television, banning cigarette commercials, and prohibiting smoking in so many public and private places, has saved hundreds of billions of dollars in unnecessary health care costs.

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.

Requiring smokers to quit if they want taxpayers to continue to subsidize their health care costs would provide a strong financial incentive to stop smoking and thereby slash those costs.  Those who refuse to quit would pay for the privilege, rather than forcing taxpayers to continue to subsidize it.

Fewer than 10% of U.S. adults are severely obese [BMI > 39], but they manage to impose $60–74 billion in unnecessary medical costs each year.  Requiring them to reduce consuming enough calories to keep them grossly obese [BMI > 39] - perhaps phased in over a reasonable period of time for healthy weight loss - in order to have their health care continue to be subsidized is fairer than forcing taxpayers to subsidize their excessive consumption.

Almost 75& of U.S. adults do not meet the federal government's Physical Activity Guidelines, and their failure to engage in the minimal amount of exercise for good health produces unnecessary medical care costs of over $115 billion each and every year. Requiring they to pay their fair share of these unnecessary costs would provide a strong incentive for them to exercise; thereby slashing costs under the ACA.  Those who refuse would simply pay the cost of their refusal.

The amount of daily exercise can easily to measured by fitness trackers (bracelets or watches) which cost less than $25; including some which will permit transmitting the results for review if necessary.
As one famous bumper sticker proclaimed - He's YOUR Monkey, Keep Him of MY back!"

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