States Have Unique Opportunity to Help Provide Quit Smoking Coverage to Medicaid Expansion Enrollees, Saving Lives and Cutting Healthcare Costs

There are 35 states and the District of Columbia that expanded Medicaid under the Affordable Care Act (ACA), providing millions of previously uninsured Americans healthcare coverage, including quit smoking treatments. A new American Lung Association report released today shows that while some states have improved coverage of quit smoking treatments for the Medicaid expansion population, most states are still falling short.  

The new “Medicaid Expansion: State Tobacco Cessation Coverage” report highlights data from 2019 as an update from a previous, first-ever 2016 report produced by the Lung Association. The updated report shows that while states have made progress since 2016 in improving coverage of quit smoking treatments for Medicaid expansion enrollees, more improvement in terms of coverage and especially removing barriers, such as co-pays and prior authorization, that prevent enrollees from accessing these treatments, are still urgently needed. 

“It can take six to 11 attempts to quit smoking, which means we need to provide as much support as possible if we want Americans to end this deadly addiction. The American Lung Association urges all states to join the fight, whether that’s through Medicaid expansion or offering more comprehensive coverage for existing expansion states,” said American Lung Association National President and CEO Harold P. Wimmer. “If we can provide quit smoking support to Medicaid expansion enrollees, we will save lives, reduce the nation’s healthcare costs and reduce the number of preventable lung diseases in the United States.”

The new report finds that all expansion states provide coverage of at least some type of medication for all expansion enrollees, but only 12 states provide coverage of group and individual counseling to all expansion enrollees in 2019. Additionally, only one state has removed all barriers for expansion enrollees to access treatment, up from zero in 2016. 

“We are disappointed that states are not doing more to help provide coverage to these individuals to help them quit smoking, when it would benefit not only the individual, but the larger community, both in terms of public health and financially,” Wimmer said.

As more states expand their Medicaid program, it is vitally important that they provide a comprehensive quit smoking benefit without barriers to realize the potential of expansion. Recent studies have shown higher rates of Medicaid enrollee quit attempts in expansion states compared to non-expansion states. By improving quit smoking coverage in Medicaid expansion programs, more people can access help quitting smoking, saving lives and money. 

The states that provide a comprehensive cessation benefit through Medicaid have also saved money in healthcare costs, including studies that found reduced heart attacks and related hospitalizations within the first two years of the benefit. One analysis found that Massachusetts Medicaid saw a three-to-one return on investment when it helped its tobacco users on Medicaid quit.

To learn more about the study released today, read the fact sheet on Lung.org. The Lung Association will host a webinar to cover the report findings on July 11, 2019 at 2:30 p.m. ET (click here to register). The study’s lead author is available for media interviews upon request. To arrange an interview or to speak with an expert about lung health, tobacco use and tobacco policies and Medicaid coverage, contact Stephanie Goldina at [email protected] or 312-801-7629.