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States Urged to Fill Gap in Helping Smokers Quit

TUESDAY Nov. 9, 2010 -- The U.S. health care reform law offers help to the majority of smokers who are trying to quit, but states need to bridge coverage gaps to ensure that all smokers have access to smoking cessation treatments, a new American Lung Association report suggests.

There are two main areas where the health care overhaul leaves large gaps in helping smokers get access to cessation treatments, according to the report, which was released Tuesday.

The first gap affects Medicaid recipients. While the new federal law mandates cessation treatment coverage for pregnant women enrolled in Medicaid, that requirement applies to fewer than 1 million out of the approximately 58 million Medicaid recipients. The smoking rate among people enrolled in Medicaid is more than 60 percent higher than the rate in the general population, the lung association noted in its news release.

The second gap affects people on private insurance plans. The new law requires the majority of private health plans, which cover 64 percent of Americans, to cover smoking cessation treatments. However, the federal government hasn't issued guidance on what private insurers must cover. Until that happens, insurers may not provide comprehensive coverage.

According to the lung association, comprehensive coverage means easy access to seven medications and three types of counseling recommended by the U.S. Department of Health and Human Services. These include over-the-counter (patch, gum, lozenge) and prescription (patch, nasal spray, inhaler) nicotine replacement therapies; two non-nicotine prescription drugs called bupropion and varenicline; and individual, group and phone counseling.

To bridge major coverage gaps, states need to provide smoking cessation treatments to all adults enrolled in Medicaid and should require all private health plans to cover all smoking cessation treatments, the report stated.

Currently, eight states have laws or insurance regulations that require smoking cessation coverage in some or all private insurance plans: Colorado, Maryland, New Jersey, New Mexico, North Dakota, Oregon, Rhode Island and Vermont.

Six states provide comprehensive smoking cessation coverage for Medicaid recipients: Indiana, Massachusetts, Minnesota, Nevada, Oregon and Pennsylvania. The report also noted that Kentucky has approved funding to cover smoking cessation treatments for Medicaid recipients, and Hawaii requires managed-care organizations that contract with its Medicaid program to provide near-comprehensive coverage of smoking cessation treatments.

Five states provide comprehensive smoking cessation coverage to all state employees and dependents: Illinois, Maine, Nevada, New Mexico and North Dakota. Some smoking cessation coverage is provided for state employees in Montana, Nebraska and Florida.

"With federal health care reform taking effect, states have a historic opportunity today to ensure that all smokers have easy access to treatments that can help them quit," Charles D. Connor, president and CEO of the American Lung Association, said in the news release.

"This is a win-win formula," he added. "Quitting smoking not only saves smokers' health, it curbs the health costs that drain our state treasuries. Giving all smokers access to a comprehensive cessation benefit now is the right thing to do, and it's the smart thing to do."

More information

The American Cancer Society offers a guide to quitting smoking.

Posted: November 2010


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