Is Your State Helping Smokers Quit?

(July 22, 2014)

With more than 8 million Americans accessing new health insurance through the Affordable Care Act (ACA), there has never been a more crucial time for policymakers and insurance plans to act to save lives–and public dollars—by expanding and easing access to tools and treatments to help smokers quit. According to the American Lung Association's Helping Smokers Quit: Tobacco Cessation Coverage 2014 report, released on July 22, many lives and billions of state and federal dollars—including over $800 million in Medicaid spending—could be saved by ensuring that coverage under the ACA comprehensively helps smokers end their nicotine addiction.

The Lung Association's annual report reviews each state's efforts to help smokers quit and provides an up-to-date look at federal coverage and requirements for quit smoking treatments under the Affordable Care Act.

States Could Save Up to $833 Million in Medicaid Spending

The report shows that significant savings in public spending could be achieved by making sure smokers on Medicaid have broader access to comprehensive smoking cessation resources. People enrolled in traditional Medicaid smoke at much higher rates than the general population (30.1 percent versus 18.1 percent for ages 18–65). Smoking-related diseases cost Medicaid programs an average of $833 million in taxpayer dollars per state in 2013.

What is your state doing to help smokers quit? Visit the report's website and find out.

Tobacco use is the leading preventable cause of death in the United States, costing our economy up to $333 billion annually. In the report, the Lung Association asserts that:

  • Every smoker, including those on Medicaid, needs access to a comprehensive tobacco cessation benefit
  • Quit smoking treatments must be provided at no cost and be easy to access
  • Insurance plans and employers should publicize what treatments are available and how to access them
  • Insurance plans and employers should not make it harder for tobacco users to afford health insurance by charging them more in premiums

What is a comprehensive quit smoking benefit? It should include all medications FDA-approved for smoking cessation and three types of cessation counseling recommended by the Public Health Service Guideline on Treating Tobacco Use and Dependence:

  • Nicotine gum
  • Nicotine patch
  • Nicotine lozenge
  • Nicotine nasal spray
  • Nicotine inhaler
  • Bupropion
  • Varenicline
  • Individual counseling
  • Group counseling
  • Phone counseling  

In addition to making all these treatments available, the American Lung Association recommends that insurance plans and policymakers must help smokers by not requiring copays or prior authorization, and not limiting the number of times a smoker can get the benefit per year or lifetime.

Tobacco Surcharges May Put Health Insurance Out of Reach for Families

The ACA allows individual and small group insurance plans to charge tobacco users up to 50 percent more in premiums than nonsmokers. This surcharge can be a difference of thousands of dollars per year for a smoker, and the Lung Association is concerned surcharges could make health insurance unaffordable for tobacco users and their families. Eleven states, however, have chosen to limit or prohibit these surcharges. Is your state one of them?

Lack of Information about Health Plans Makes it Hard for Patients to Make Healthcare Choices

Millions of patients have enrolled in health coverage through the ACA, but many encountered barriers that make it hard to find information on what treatments health plans actually cover, including smoking cessation treatments. Patients need this information to be clear and available to make informed choices when selecting and enrolling in healthcare plans. Clear understanding of what is covered is needed to evaluate whether plans are providing the right treatments to smokers who want to quit and other patients. The American Lung Association urges the U.S. Department of Health and Human Services to require that health plans make this information publically available.

Three Bold Goals

In January 2014, the American Lung Association and our public health and medical partners announced our plans to end tobacco use through the creation of three bold goals:

  1. Reduce smoking rates, currently at about 18 percent, to less than 10 percent within 10 years;
  2. Protect all Americans from secondhand smoke within five years; and
  3. Ultimately eliminate the death and disease caused by tobacco use.

Interested in helping us achieve these three bold goals?  Join our fight!