Medicaid Coverage of Tobacco Dependency Treatments

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In 2010, all 51 Medicaid programs provided coverage for at least one tobacco-dependence treatment for at least some segment of their Medicaid eligible population.

Summary graph for Medicaid Coverage of Tobacco Dependency Treatments, Click to see detailed view of graph

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Introduction

Medicaid enrollees have a higher smoking prevalence than the general population. Smoking-related diseases are a major contributor to Medicaid costs. Providing tobacco users access to evidence-based tobacco dependence treatments can reduce morbidity and mortality from cancers and other tobacco-related diseases and reduce Medicaid costs (Source: https://www.cdc.gov/coordinatedchronic/pdf/tobacco_cessation_factsheet_508_compliant.pdf). 

All state Medicaid programs must provide tobacco cessation services (both counseling and pharmacotherapy) for pregnant women under section 4107 of the 2010 Patient Protection and Affordable Care Act (ACA). Additionally, effective January 2014, section 2502 of the ACA barred state Medicaid programs from excluding coverage for cessation medications approved by the U.S. Food and Drug Administration. However, coverage still varies widely by state. As of June 2015, only nine states cover nine evidence-based cessation treatments (seven medications, individual, and group counseling) for all Medicaid enrollees. As of September 2017, only 11 states provided comprehensive coverage of all nine evidence-based cessation treatments (medications, individual and group counseling) for all Medicaid enrollees. Expansion of treatment coverage and eligibility while reducing barriers to treatment access (e.g. copays, duration limits on treatment) are still needed.

Measure

The number of states that provide coverage under Medicaid for any evidence-based tobacco dependence treatment (pharmacotherapy or counseling), either to their entire Medicaid population or to only pregnant women.

The number of states that provide coverage under Medicaid for individual or group tobacco cessation counseling.

The number of states that provide coverage under Medicaid for tobacco cessation medications.

Healthy People 2020 Target

  • Increase comprehensive Medicaid insurance coverage of evidence-based treatment for nicotine dependency in States and the District of Columbia.

Healthy People 2020 is a set of goals set forth by the Department of Health and Human Services.
Note: Goals are indicated as blue line on Detailed Trend Graphs.

Data Source

Centers for Disease Control and Prevention. State Medicaid coverage for tobacco-cessation treatments and barriers to coverage – United States, 2014-2015. MMWR 2015;64(42):1194-9.

Trends and Most Recent EstimatesHelp with navigating the graphs and data tables

Medicaid Coverage of Cessation Aids

Medicaid Coverage of at least one tobacco-dependence treatment for at least some enrollees in the 50 states and DC, 1990-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Number of states 95% Confidence Interval
Thumbnail of graph for Medicaid coverage of smoking cessation aids in the 50 states and DC, 1990-2016 Medicaid Coverage of Cessation AidsClick to see the detailed trend graph for Medicaid Coverage of Cessation Aids 51.0 Not available

Medicaid Coverage of Cessation Counseling

Breakdown of state Medicaid coverage for tobacco cessation counseling, 2014-2016
Overview graph Counseling Type Number of States (2016)
Yes Pregnant
women only
Varies
by plan
No
Thumbnail of graph for Breakdown of state Medicaid coverage for tobacco cessation counseling click for more details and datapoints Individual 33 5 11 2
Group 12 3 19 18

Medicaid Coverage of Smoking Cessation Medications

Breakdown of state Medicaid coverage for tobacco cessation medications, 2014-2016
Overview graph Medication Number of States (2016)
Yes Pregnant
women only
Varies
by plan
No
Thumbnail of graph for Breakdown of state Medicaid coverage for tobacco cessation medications click for more details and datapoints Nicotine Patch 46 0 4 1
Nicotine Gum 44 0 6 1
Nicotine Lozenge 37 0 12 2
Nicotine Nasal Spray 33 0 13 5
Nicotine Inhaler 32 0 13 6
Bupropion 50 0 1 0
Varenicline 45 0 6 0

Additional Information on Medicaid Coverage of Tobacco Dependency Treatments

For the public

For health professionals

Scientific reports

Statistics

For tobacco users

Year Range

1990-2010

Recent Summary Trend Year Range

2006-2010

Summary Tables

Tobacco Company Marketing Expenditures

Recent Summary Trend

Rising

Desired Direction

Rising