The Lung Association’s annual report reviews each state’s efforts to help smokers quit and provides an up-to-date look at federal coverage and requirements for quit smoking treatments under the Affordable Care Act.
Although Nebraska members are limited to 2 quit attempts per year, the report indicates Nebraska is doing an adequate job at covering most cessation methods.
As of July 17th 2014, Nebraska covers the cost of Nicotine replacement gum and patches, 2 types of medication (Chantix and Zyban), and individual counseling.
The report noted that significant savings in public spending could be achieved by making sure smokers on Medicaid have broader access to comprehensive smoking cessation resources.
People enrolled in traditional Medicaid smoke at much higher rates than the general population (30.1 percent versus 18.1 percent for ages 18–65). Smoking-related diseases cost Medicaid programs an average of $833 million in taxpayer dollars per state in 2013. The Lung Association’s report determined that:
Only two states provide comprehensive cessation coverage for all Medicaid enrollees: Indiana and Massachusetts;
Several states, including Alabama, Connecticut, Georgia, Maine, Ohio and Vermont, improved Medicaid cessation coverage for smokers since last year;
Thirty five states charge copays for tobacco cessation treatments for individuals enrolled in Medicaid – even though evidence shows copays discourage use of treatment and many plans with higher-income enrollees are prohibited from charging them.
Tobacco use is the leading preventable cause of death in the United States, costing our economy up to $333 billion annually.
In the report, the American Lung Association asserts that:
· Every smoker, including those on Medicaid, needs access to a comprehensive tobacco cessation benefit
· Quit smoking treatments must be provided at no cost and be easy to access
· Insurance plans and employers should publicize what treatments are available and how to access them
· Insurance plans and employers should not make it harder for tobacco users to afford health insurance by charging them more in premiums
A comprehensive quit smoking benefit includes all medications FDA-approved for smoking cessation and three types of cessation counseling recommended by the Public Health Service Guideline on Treating Tobacco Use and Dependence:
Nicotine nasal spray
The ACA allows individual and small group insurance plans to charge tobacco users up to 50 percent more in premiums than nonsmokers. This surcharge can be a difference of thousands of dollars per year for a smoker, and the Lung Association is concerned surcharges could make health insurance unaffordable for tobacco users and their families. Eleven states, however, have chosen to limit or prohibit these surcharges.