Domenech was the managing editor of healthcare policy at The Heartland Institute, writing numerous columns advocating abolishing Obamacare, and defending Republican alternatives. The Heartland Institute itself, during this time, was funded in part by Philip Morris and other tobacco companies, which at the time were working behind the scenes to defeat Obamcacare. On Feb. 7, 2013, Domenech appeared on a Heartland podcast, during which he spoke about how, in his view, smokers were being singled out for rate hikes, and other unfair treatment under Obamacare, a position long held by Philip Morris and other tobacco companies. Domenech argued on the podcast that smokers are more likely to die earlier than other people, and thus are less costly to insurance companies and the government.