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. 

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 2018, only 12 states provided comprehensive coverage of all 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. 1

The number of states that provide coverage under Medicaid for tobacco cessation medications. 1

1 Definitions

Covered: This service is provided for all individuals enrolled in Medicaid.
Coverage Varies by Plan: If fee-for-service and managed care plans provide different coverage of this service, it was classified as “Varies by Plan.”
Pregnant Women Only: This service is provided only for pregnant women
Note: For Both fee-for-service and managed care plans were considered. If a state reported “Not Applicable” for one plan, what was reported for the other plan was used. Otherwise, if the report for fee-for-service and managed care plans did not match, it was classified as “Varies by Plan.” If fee-for-service and managed care plans did match, they were classified as such.

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 Tobacco Activities Tracking and Evaluation (STATE) System.

McMenamin SB, Haplin HA, Bellows MN, Husten CG, Rosenthal A. State Medicaid coverage for tobacco-dependance treatments - United States, 2007. Morbidity and Mortality Weekly Report 2009;58(43);1199-1204.

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

Medicaid Coverage of Cessation Treatements

Medicaid Coverage of at least one tobacco-dependence treatment for at least some enrollees in the 50 states and DC, 1990-2010
Overview Graph Detailed Trend Graphs Most Recent Estimates (2010)
Number of States 95% Confidence Interval
Thumbnail of graph for Medicaid Coverage of at least one tobacco-dependence treatment for at least some enrollees in the 50 states and DC, 1990-2010 Medicaid Coverage of Cessation TreatmentsClick to see the detailed trend graph for Medicaid Coverage of Cessation Treatments 51.0 Not available

Medicaid Coverage for Group Cessation Counseling

State Medicaid coverage for tobacco cessation group counseling by level of coverage, 2008-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Number of U.S. states 95% Confidence Interval
Thumbnail of graph for State Medicaid coverage for tobacco cessation group counseling by level of coverage, 2008-2017 CoveredClick to see the detailed trend graph for Covered 13.0 Not available
Pregnant Women OnlyClick to see the detailed trend graph for Pregnant Women Only 2.0 Not available
Coverage Varies by PlanClick to see the detailed trend graph for Coverage Varies by Plan 16.0 Not available

Medicaid Coverage for Individual Cessation Counseling

State Medicaid coverage for tobacco cessation individual counseling by level of coverage, 2008-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Number of U.S. states 95% Confidence Interval
Thumbnail of graph for State Medicaid coverage for tobacco cessation individual counseling by level of coverage, 2008-2017 CoveredClick to see the detailed trend graph for Covered 35.0 Not available
Pregnant Women OnlyClick to see the detailed trend graph for Pregnant Women Only 6.0 Not available
Coverage Varies by PlanClick to see the detailed trend graph for Coverage Varies by Plan 8.0 Not available

Medicaid Coverage for Cessation Aids

State Medicaid coverage for tobacco cessation aids by medication availablity and level of coverage, 2008-2017
Overview Graph Detailed Trend Graphs Most Recent Estimates (2017)
Number of U.S. states 95% Confidence Interval
Thumbnail of graph for State Medicaid coverage for tobacco cessation aids by medication availablity and level of coverage, 2008-2017 Over-the-Counter Aids CoveredClick to see the detailed trend graph for Over-the-Counter Aids Covered 49.0 Not available
Prescription Aids CoveredClick to see the detailed trend graph for Prescription Aids Covered 50.0 Not available
OTC Coverage Varies by PlanClick to see the detailed trend graph for OTC Coverage Varies by Plan 1.0 Not available
Prescription Coverage Varies by PlanClick to see the detailed trend graph for Prescription Coverage Varies by Plan 1.0 Not available

Additional Information on Medicaid Coverage of Tobacco Dependency Treatments

For the public

For tobacco users

For health professionals

Scientific reports

Statistics

Year Range

1990-2010

Recent Summary Trend Year Range

2006-2010

Summary Tables

Tobacco Company Marketing Expenditures

Recent Summary Trend

Rising

Desired Direction

Rising