State Medicaid Coverage for Tobacco-Dependence Treatments—United States, 2007

MMWR Introduction

Despite a high smoking prevalence (33%) of adult Medicaid recipients, only 6 states provided the recommended full coverage of all tobacco-dependence treatments (FDA-approved medications and counseling) to help smokers quit. Additionally, there are few programs that provide treatment services with no restrictions or barriers. In all but 2 of 51 Medicaid programs, accessibility is limited by various barriers such as copayments, limitations in duration of treatment, and prior authorization. Furthermore, this MMWR found that Medicaid coverage varied widely among states and among enrollees within the same program.

Expenditures associated with smoking costs Medicaid nearly $22 billion annually; representing 11% of all Medicaid expenditures. To decrease these costs and reduce smoking prevalence, there are specific health goals that have been identified. The updated 2008 Public Health Service Clinical Practice Guideline called upon all insurers, including Medicaid, to provide comprehensive coverage of effective treatments—both counseling and medication—without restrictions or limitations. In addition, Healthy People 2010 aims to increase coverage of evidence-based treatments for nicotine dependence to all 51 Medicaid programs. To meet these goals, Medicaid programs must continue to improve and expand their tobacco-dependence treatment services.