Silly me. For most of my adult life I’ve been led to believe that tobacco consumption is one of the key health issues facing Californians.

After all, Californians have twice raised taxes on tobacco, and narrowly rejected another increase last June, to the dismay of politicos and health advocates.

Proceeds from the 1988 tax increases were used to produce widely-hailed advertisements castigating not only smoking, but the tobacco companies themselves.

Smoking has been outlawed in the workplace and many public places, including parks and beaches. Nobody, it seems, can outdo California’s political and health leaders when it comes to cracking down on tobacco use.

Except, it turns out, California’s political and health leaders.

In yet another episode of Big Government Gone Haywire, both the California Legislature and the California Health Exchange are poised to turn back the clock on sensible wellness incentives.

Chronic (and preventable) diseases are among the most significant drivers of health care costs. PricewaterhouseCoopers found in 2008 that “approximately $303 billion to $493 billion annually is spent treating preventable illnesses, such as those due to obesity, smoking, failure to follow medical directives, and alcohol abuse. The federal Affordable Care Act recognized this by allowing premium rates charged by health insurers to vary only by family composition, age, geographical location, and tobacco use. The Act also allows wellness incentives to vary premiums by up to thirty percent.

But in California, legislation awaiting final passage (AB 1083) explicitly prohibits insurers from rating premiums for certain group plans based on tobacco use, and rejects any incentives for wellness programs. And across town, the Health Benefits Exchange is considering a staff recommendation to define a “Qualified Health Plan” to include “Prohibit(ing) the application of tobacco rating factors.”

Only in the topsy-turvy world of California policy makers would a transparent, consumer-focused, market-based tool for improving health care be rejected, in the face of not only evidence, but the rhetoric of these self-same advocates.