Most Americans get help quitting smoking for free. The poorest Americans don't.
That's because the Affordable Care Act required all private insurance plans to cover tobacco cessation treatment at no charge to the patient. But Medicaid, a state-run public health program for the low-income and disabled, has no such mandate.
And Medicaid beneficiaries are paying for it. A new report from the Centers for Disease Control and Prevention finds that states don't offer many of the Health and Human Services Department's recommended treatments, and the services they do cover come with co-pays, limits on the duration of use, and other barriers to access for Medicaid patients.
While all states cover some kind of tobacco cessation treatment in their Medicaid programs, the report finds, only seven states cover all seven FDA-approved medications and two recommended forms of cessation counseling (individual and group).
There's a demand for the services, too. Medicaid beneficiaries have higher smoking rates than the general population, CDC data finds, with 30.1 percent of Medicaid enrollees under the age of 65 smoking, compared with 18.1 percent of all U.S. adults.
"Smoking-related disease is a major contributor to increasing Medicaid costs," the report says. "The evidence from previous analyses suggests that states could reduce smoking-related morbidity and health-care costs among Medicaid enrollees by providing Medicaid coverage for all evidence-based cessation treatments, removing all barriers to accessing these treatments, promoting the coverage, and monitoring its use."