RICHMOND, Va. (WRIC) – A chopping block bill this week could impact health insurance prices for smokers and non-smokers alike across Virginia.

If the General Assembly overrides Governor Glenn Youngkin’s veto and the legislation is signed into law, it would prohibit insurance companies from charging tobacco users up to 50% more than non-smokers starting January 1, 2023 .

At least six other states and Washington DC have already banned the practice, as many argue that the additional charges, authorized by the Affordable Care Act, are not working as intended.

Governor Youngkin’s veto puts him at odds with a bipartisan group of lawmakers, a nonpartisan report and a coalition of advocacy groups. A version of the bill passed with unanimous support in the Senate and a 72-27 vote in the House of Delegates.

In his written explanation, Youngkin said smoking is one of the leading causes of chronic health conditions that lead to higher healthcare costs.

“This legislation would require insurance companies to recover costs associated with smokers by increasing premiums for non-smokers,” Youngkin said. “The ability to reduce premiums by quitting smoking is also a valuable incentive to encourage healthier habits.”

Youngkin defended this position during an interview on Friday.

“When, in fact, we artificially deflate a premium that by definition requires more expenditure for smokers, we actually have a real risk of crowding people out of the insurance market,” Youngkin said.

Youngkin’s veto prompted the American Lung Association, the American Cancer Society Cancer Action Network, the Virginia Poverty Law Center and the Commonwealth Institute for Fiscal Analysis to back down.

In a joint letter to Virginia Health and Human Resources Secretary John Littel, the groups said Youngkin’s reasoning is consistent with the original goals of the tobacco surcharges, but more recent evidence supports their elimination.

“Surprisingly, they were found to be doing the opposite: increasing premiums, reducing enrollment and limiting access to smoking cessation services. As such, it is time to abandon this failed intervention,” the letter continues.

Delegate Patrick Hope, who sponsored the bill, said he was caught off guard by Youngkin’s veto.

“He didn’t warn me. There was no discussion, no conversation about it,” Hope said. “I hope they will see that the governor’s veto was a mistake.”

Hope said the surcharge prevents some smokers from accessing insurance, as well as programs to help them quit. He said higher prices largely deter young people who use tobacco from signing up for coverage, which skews the risk pool towards those with higher health needs.

A 2021 report examining the affordability of insurance in Virginia found that bringing more healthy people into the market would “likely reduce premiums.”

Specifically, the Joint Commission on Health Care found that eliminating tobacco surcharges could reduce premiums in the individual market by 3% to 4.5% and reduce the number of uninsured Virginians by 3,000 to 14,000, depending on other political factors. The recommendation was adopted unanimously by JCHC members from both parties.

“If we expect this to reduce premiums by 4.5%, that’s a savings for Virginians of $15.44 per month or $157.78 over the year,” Hope estimated. “Every Virginian who is part of the individual insurance pool will benefit from the coming into force of this bill.”

For the bill to become law, the General Assembly will need to override Governor Youngkin’s veto by a two-thirds vote in a session scheduled for Wednesday, April 27. Hope acknowledged that it could be an uphill battle to get Republicans to publicly disagree with Youngkin, even though they have supported the bill before.

Asked to respond to Democrats like Hope, who say the governor has made no effort to reach out before vetoing important bills, Youngkin said, “We’ve had a full process to try to reaching out to legislators and talking to them about amendments and vetoes and I believe that working relationship is constructive.