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Might be sooner than you think considering they are talking about letting 16-17 years old vote in state and federal elections.
As for OP how about we just live and let live? People pay into Medicare so let them do as they choose. Most studies show that smokers and fat people require less healthcare over the span of their lives because they something like 20+ less years. You want Medicare prices to go down? Best thing is to start pushing people towards sugar, tobacco, and alcohol. Hell, it would likely decrease greenhouse gases since over the course of ~70 years the population would being to dwindle.
I posted about Medicaid and not Medicare