Obama Administration Takes Critical Step to Help Smokers Quit and Save Lives
Important ACA guidance could help millions of smokers get the help they need to quit.
(May 2, 2014) - Washington, D.C.
Today, the Obama Administration issued guidance on quit smoking benefits available through the Affordable Care Act (ACA). This important announcement from the Departments implementing the ACA (Health and Human Services, Labor and Treasury) clarifies what treatments insurance plans should cover for quitting smoking as part of their preventive services benefit. This guidance will help to ensure that employers and insurance plans are doing everything they can to get smokers they help they need to quit.
“The American Lung Association commends the Obama Administration for today’s lifesaving announcement,” said Harold Wimmer, National President and CEO of the American Lung Association. “Quitting is hard and the Lung Association knows that making sure everyone has access to all quit smoking medications and counseling is critical to saving lives.”
The guidance issued today defines what an appropriate comprehensive quit smoking benefit is. According to the Obama Administration, a comprehensive benefit includes coverage of:
- All medications approved by the FDA as safe and effective for smoking cessation
- Individual, group and phone cessation counseling
- These quit smoking benefits should be offered at least twice a year to smokers, recognizing not everyone quits on their first try
- Plans should not require prior authorization for these benefits
The ACA also requires that these benefits be provided at no cost to the patient – so no copays, coinsurance or deductibles should be charged.
It is crucial that each smoker who wants to quit has access to all treatments that will help. Quitting smoking is not a “one-size-fits-all” process. The American Lung Association and its partners have urged the Obama Administration to provide this guidance on quit smoking benefits since 2010. Most recently, the Lung Association and 29 public health and medical organizations sent this letter in February 2014 calling for the Administration to clarify the benefit.
Prior to this guidance, most insurance plans have not implemented comprehensive cessation benefits. The Lung Association believes this clarification will help rectify the wide variation in how insurance companies have previously implemented this requirement in the private insurance market. One study by the Georgetown University Health Policy Institute, commissioned by the Campaign for Tobacco-Free Kids, found that only four of 39 private plans analyzed covered even close to a comprehensive benefit. Also troubling, some of the plans analyzed included cost sharing for tobacco cessation treatments – something prohibited by the ACA. Another survey in Colorado found that there has been significant variance in the ways health plans in Colorado have implemented the requirement. Interestingly, these variances were seen in the area of tobacco cessation more so than other areas of preventive services.
The recent Surgeon General’s report on smoking and health concluded that more than 42 million Americans still smoke. Today’s guidance will affect health coverage provided to all populations that smoke including those that smoke at higher rates than the general population; like low-income Americans, Medicaid expansion enrollees and Americans who were previously uninsured According to the same survey, 69 percent of current smokers in America want to quit.
The Lung Association has been successfully helping smokers quit for more than 30 years with our Freedom From Smoking® program. In addition, the Lung Association's Not-On-Tobacco® (N-O-T) program is designed for smokers aged 14 to 19 who want to quit and is America's most popular smoking cessation program for teens. For assistance with quitting smoking or for additional questions about lung health, please call the American Lung Association's Lung HelpLine at 1-800-LUNGUSA (1-800-586-4872).
The American Lung Association also provides many resources on Affordable Care Act implementation and lung health. Please visit www.lung.org/acatoolkit for more information. To read American Lung Association letters and comments submitted on this issue, please visit http://www.lung.org/get-involved/advocate/advocacy-archive.html.