Prevention Matters

Partnership for Prevention’s ActionToQuit initiative has developed a comprehensive state-by-state analysis of Medicaid coverage of tobacco cessation. Prepared in collaboration with the American Lung Association, Saving Lives and Money – Helping People on Medicaid Quit Tobacco offers clear guidance to states on necessary steps to provide a comprehensive cessation benefit in accordance with recommendations of the United States Public Health Service (USPHS).

In 2004, the U.S. Medicaid expenditures for tobacco related illnesses totaled $22 billion, which was 11% of the overall Medicaid expenditure. States like New Hampshire and Montana, with smoking prevalence rates among the Medicaid population at 80% and 70% respectively, both attributed 15% of Medicaid costs to smoking. Their combined smoking attributable costs to Medicaid were $173 million. Although both Arizona and Washington’s prevalence rates were lower than 70% in 2004, both states attributed 18% of Medicaid costs to smoking, totaling $841 million. Since a large portion of Medicaid’s funding goes toward treating tobacco related diseases, an up-front investment in prevention, including tobacco cessation, must be a consideration.

As mapped out in Saving Lives and Money, six states currently cover all the treatments Medicaid recipients need to quit tobacco – Minnesota, Indiana, Massachusetts, Nevada, Oregon and Pennsylvania. Twenty-one states provide most, but not all, recommended cessation treatments to all of their Medicaid recipients; eighteen states provide only a few cessation treatments or have uneven coverage; and four states fail to cover any of the recommended medications or counseling for Medicaid recipients who want to quit.

The 2010 Patient Protection and Affordable Care Act requires that all Medicaid programs cover a comprehensive cessation benefit for pregnant women on Medicaid beginning this fall. The Act also provides a one percentage point increase in the federal Medicaid matching rate to states that cover all preventive services given an ‘A’ or ‘B’ by the USPHS (including tobacco cessation) with no cost-sharing. These are important steps in the right direction but, as Saving Lives and Money points out, there is still much to be done.

The guide will be introduced next week at an important session of the National Conference of State Legislatures’ (NCSL) Health Committee meeting in Louisville, Kentucky. At Partnership’s urging, this year the NCSL Health Committee is hearing a presentation on the remarkable success of the Massachusetts Medicaid program in promoting a comprehensive tobacco cessation benefit and achieving unprecedented success in reducing tobacco prevalence among the Medicaid population and reducing tobacco related health care costs.

Please visit the ActionToQuit website, Resources section to download the guide: http://actiontoquit.org/resources/


Brandi Robinson
Program Associate
Partnership for Prevention