National Working Group for ACTTION

August 27, 2010

Dear Partners:

In late July, Partnership for Prevention’s ActionToQuit initiative was pleased to release its new guide, Save Lives and Money – Help People on Medicaid Quit Tobacco.  The guide, prepared in collaboration with the American Lung Association, was released at the National Conference of State Legislators meeting in Louisville, Kentucky.  You can access the guide here.

During the NCSL meeting, the Health Committee, at the initiation of Partnership for Prevention, hosted a special tobacco cessation briefing for state legislators and their staff members from across the country.  The briefing focused on the impact the Massachusetts Medicaid program experienced when it offered and promoted a comprehensive tobacco cessation benefit. Although states have achieved many tobacco control policy advances in smoke free air laws and increased tobacco taxes, policies related to cessation have often lagged behind.  The briefing on Massachusetts’ success combined with the release of the guide was intended to encourage other states to follow Massachusetts’ example.

The entire Health Committee meeting can be seen at
http://www.ncsl.org/default.aspx?tabid=20770.

The Medicaid population has a high rate of tobacco use. In 2004, U.S. Medicaid expenditures for illnesses caused by tobacco totaled $22 billion, or 11% of the entire Medicaid budget.  Because so much of Medicaid's funding goes toward tobacco-related diseases, an up-front investment in prevention (i.e. tobacco cessation) is likely to have a high pay-off.

Following a comprehensive state-by-state analysis of Medicaid coverage of tobacco cessation, Save Lives and Money provides guidance to states on necessary steps to provide a comprehensive cessation benefit in accordance with recommendations of the United States Public Health Service.

The key points for advocates and legislators to include in developing a comprehensive benefit are:

• Every health plan offered to Medicaid recipients should provide comprehensive cessation benefits-- the seven medications (prescription and over the counter) and the counseling proven effective in helping patients quit tobacco.

• Remove arbitrary barriers that limit access to cessation treatments.

• Communicate widely the availability of cessation benefits.

• Make it easy for Medicaid recipients to find information about the coverage and understand how to use it.

• Inform Medicaid recipients that state quitlines provide phone counseling.

The guide should be immediately helpful to those who want to increase access to cessation services for Medicaid recipients.  It will also be supportive as provisions of the 2010 Patient Protection and Affordable Care Act that affect state Medicaid coverage of tobacco cessation come into effect.

• As of October 1st, 2010, all Medicaid programs will be required to provide a comprehensive cessation benefit for pregnant women on Medicaid.

• The legislation removes tobacco cessation medications from the list of excludable medications. This means that Medicaid programs may no longer explicitly exclude these treatments from coverage.

• States that cover all preventive services given an ‘A’ or ‘B’ by the U.S. Preventive Services Task Force (including tobacco cessation) with no cost-sharing will begin receiving a one percentage point increase in the federal Medicaid matching rate for those services starting in 2014.

While these are important steps in the right direction, there is still much to be done. The most important thing to note is that federal health care reform only requires tobacco cessation coverage for pregnant women. States can save lives and save money by acting to give all Medicaid recipients access to comprehensive treatment.

Regards,

Diane Canova, JD
Vice President, Policy & Programs
Partnership for Prevention