The Affordable Care Act (ACA) requires most private insurance plans, including any plan sold in the exchange, to cover any services or treatment with an “A” or “B” from the United States Preventive Services Task Force (USPSTF) without cost-sharing. Tobacco cessation receives an “A” grade. While many plans are covering these treatments, there is still room for improvement.
Each state has an Insurance Commissioner who regulates insurance products, including health insurance in their state. State Insurance Commissioners can provide clarification on what should be covered in terms of tobacco cessation to insurance companies in the form of insurance bulletins. These commissioners can also provide similar clarification to consumers in the form consumer alerts. Since this is the insurance regulator, they have additional steps to take to ensure coverage.
This toolkit is designed for state tobacco control staff (and their coalitions) to work with state Insurance Commissioners to work for better tobacco cessation coverage in private insurance and specifically in exchange plans.
Page last updated: July 20, 2021