“Preliminary research suggests Medicaid waivers allowing states to charge premiums up to 4% of family income, and add surcharges to the premiums of smokers, might lessen the number low income individuals taking advantage of the expanded Medicaid program. If this is the case, will these waivers negatively impact both the goals of the ACA and safety net hospitals?” try to simplify this a bit.. and also tighten up the question a bit.

“Preliminary research suggests Medicaid waivers allowing states to charge premiums up to 4% of family income, and add surcharges to the premiums of smokers, might lessen the number low income individuals taking advantage of the expanded Medicaid program. If this is the case, will these waivers negatively impact both the goals of the ACA and safety net hospitals?” try to simplify this a bit.. and also tighten up the question a bit.

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