Americans to get needed help to quit smoking through federal health care law: New report

Despite Federal Health Care Overhaul, Gaps Remain in Helping Smokers Quit

Millions of Americans will get needed help to quit smoking thanks to the newly enacted U.S. health care law, and it is up to states to close a gap that still remains for other smokers, a new American Lung Association report finds.

In its new report, "Helping Smokers Quit: State Cessation Coverage 2010," the American Lung Association applauds important advances in the federal health care overhaul, offering a vast majority of Americans help in ending their deadly tobacco addiction. But millions of other smokers still cannot easily get treatments to help them quit.  States can bridge the gap as some demonstrated in 2010. Studies show this can be done without breaking budgets.

"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," said American Lung President and CEO Charles D. Connor. "When it comes to quit-smoking treatments that save lives, it's crucial that state policymakers close the coverage gap. The federal government has gone a long way to address the problem, but much more can be done."

Providing comprehensive coverage means requiring easy access to seven medications and three types of counseling recommended by the U.S. Department of Health and Human Services (HHS) to treat tobacco use and nicotine dependence. Nicotine replacement therapies (NRTs) are available over the counter (patch, gum, lozenge) and by prescription (patch, nasal spray, inhaler), and there are two non-nicotine, prescription-only medications, called bupropion and varenicline. Recommended types of counseling include individual (face-to-face), group and phone.

The annual report provides an overview of cessation (quit-smoking) services and treatments offered in each state by public and private health care plans and the impact of the federal health care law. Parts of the new law have taken effect in 2010, and states are already making changes to their public and private health care systems as they implement the law.

The report identifies two key areas where the new federal law—while advancing a national prevention and wellness strategy—leaves a large gap in helping smokers get access to cessation treatments:

• Medicaid: The new law requires cessation treatment coverage for pregnant women enrolled in Medicaid, the joint federal and state health program for low-income people. This requirement applies to fewer than a million out of the roughly 58 million on Medicaid. People enrolled in Medicaid smoke at a rate over 60 percent higher than the general population.
• Private Insurance: Federal law requires for the first time that the majority of private health plans, which cover 64 percent of Americans, must offer tobacco cessation treatments. However, the government still must issue guidance on what private insurance companies must cover.  Until that guidance is issued, the Lung Association is concerned that insurance plans may not provide the comprehensive benefits.

According to the Lung Association's new report, states need to step forward and provide smoking cessation treatments to all adults enrolled in Medicaid.  States also should bridge a crucial coverage gap by requiring that all private health plans cover all quit-smoking treatments.

The "Helping Smokers Quit" report also identifies states that made positive strides in 2010, including:

• Kentucky, a tobacco-producing state, approved funding to help Medicaid recipients quit smoking through coverage of tobacco cessation treatments. Kentucky has come close to the gold standard of providing comprehensive quit-smoking coverage for Medicaid recipients set by six other states; they are Indiana, Massachusetts, Minnesota, Nevada, Oregon and Pennsylvania.
• Hawaii also took a big step, requiring managed-care organizations that contract with its Medicaid program to provide near-comprehensive coverage of tobacco cessation treatments.
• Montana, Nebraska and Florida began providing some quit-smoking benefits for state employees after having offered no help in the past to those who wanted to stop. Currently five other states lead the way in providing comprehensive coverage to all state employees and dependents; they are Illinois, Maine, Nevada, New Mexico and North Dakota.

More states need to follow these examples, the report urges. It also notes that eight states currently have laws or insurance regulations requiring smoking cessation coverage in some or all private insurance plans. They are Colorado, Maryland, New Jersey, New Mexico, North Dakota, Oregon, Rhode Island and Vermont.

According to the report, it is urgent for states to improve smoking cessation coverage now because more smokers are attempting to quit as they encounter an increasing number of smokefree laws and higher tobacco prices, and as the human and financial tolls of tobacco continue to rise.

Every year 443,000 people die from tobacco-related illnesses and secondhand smoke exposure, making tobacco the leading cause of preventable death. Quitting smoking has been shown to be the most important step a smoker can take to improve the length and quality of his or her life.

Quitting smoking is difficult, and most smokers need help in order to quit successfully. Many people do not have access to, or do not know about, effective treatments that will help them quit for good. It is imperative that states have policies in place to help these smokers quit and make sure smokers are aware of them.

A recent study by researchers at Penn State University found that helping smokers quit not only saves lives, but also offers favorable economic benefits to states. The American Lung Association calls upon each state to provide all Medicaid recipients, state employees and those with private insurance with comprehensive, easily-accessible tobacco cessation medications and counseling.

"This is a win-win formula," Connor said. "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."

SOURCE American Lung Association