State Medicaid Programs Show Limited Progress in Providing Coverage to Help Smokers Quit

The new article, "State Medicaid Coverage for Tobacco Cessation Treatments and Barriers to Accessing Treatments—United States, 2015–2017" shows efforts by states to help their Medicaid enrollees quit smoking only improved slightly from 2015 to 2017, missing the opportunity to help millions get the help they need to improve their health. The report published in this week's Morbidity and Mortality Weekly Report finds that Medicaid coverage of quit-smoking treatment continues to fall short in helping smokers quit.

Medicaid enrollees continue to smoke cigarettes at a rate more than twice as high as that of privately insured Americans, placing them at increased risk for smoking-related disease and death. This week's article, authored by the American Lung Association and the U.S. Centers for Disease Control and Prevention (CDC), finds that coverage across the country still fails to meet the goals set by the U.S. Department of Health and Human Services' Healthy People 2020 initiative of comprehensive coverage in all 50 states and the District of Columbia. It also reveals that significant barriers, such as prior authorization, are holding Medicaid enrollees back from accessing the treatment they need to quit smoking.

"Medicaid enrollees especially have an urgent need for quit-smoking coverage, and by allowing barriers and gaps in cessation coverage, we are missing a critical chance to save thousands of lives, while also incurring almost $40 billion in Medicaid spending per year to treat tobacco-related illness that could otherwise be prevented," said American Lung Association National President and CEO Harold P. Wimmer.

Tobacco use is the nation's leading cause of preventable death and disease in the United States. Tobacco's toll can be reduced if state Medicaid programs improve tobacco cessation success among Medicaid enrollees by covering all evidence-based cessation treatments, removing barriers that impede access to these treatments, promoting their coverage to Medicaid tobacco users and healthcare providers, and monitoring use of covered treatments.

The American Lung Association measured the most recent trends in state Medicaid cessation coverage by collecting data on coverage of the nine evidence-based cessation treatments by state Medicaid programs, as well as data on any barriers that kept enrollees from accessing these treatments. The nine cessation treatments include the seven medications approved by the U.S. Food and Drug Administration and individual and group counseling.

Findings in the study include (as of June 30, 2017):

• 32 states cover all seven medications for all standard Medicaid enrollees, and every state and the District of Columbia cover some medications.  
• 10 states cover all nine quit-smoking treatments for all standard Medicaid enrollees.
• Only one state, Missouri, has removed all barriers to accessing quit-smoking treatments for all standard Medicaid enrollees.

Not included in the study's timeframe is that Kentucky and South Carolina, which offer comprehensive coverage of the nine tobacco cessation treatments, effective July 1, 2017. This is a positive development for these two states, both of which have higher than the national average smoking rates.

"Smoking is a serious addiction, but we know how to help smokers quit and what needs to be done to help them succeed," said Wimmer. "States need to make it easier for Medicaid enrollees to quit smoking. Although Medicaid coverage has improved between 2015-2017, states can and should do more to ensure all Medicaid enrollees have access to a comprehensive cessation benefit without barriers. Taking this step should be an easy choice because it will both save lives and taxpayer dollars."

For media interested in speaking with an expert about this article or lung health, tobacco use and tobacco policies and cessation coverage, contact Allison MacMunn at [email protected] or 312-801-7628.