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Health Equity and Accountability Act of 2022 Addresses Glaring Health Disparities, Including Those Caused by Tobacco

Statement of Matthew L. Myers, President, Campaign for Tobacco-Free Kids
April 26, 2022

WASHINGTON, D.C. – The Campaign for Tobacco-Free Kids applauds Rep. Robin Kelly (D-IL), chair of the Congressional Black Caucus Health Braintrust, and the Congressional Tri-Caucus for introducing the Health Equity and Accountability Act of 2022, which provides a comprehensive strategy for addressing health disparities in the United States, including disparities caused by tobacco use. Among other things, this legislation would significantly increase tobacco taxes and expand coverage for tobacco cessation services under Medicaid and private health plans, which are proven strategies to reduce tobacco use and the death and disease it causes.

As we emerge from the COVID-19 pandemic that disproportionately harmed communities of color and exposed longstanding health disparities, the need for this legislation has only been heightened. While the U.S. has made enormous progress in reducing smoking, there are large disparities in who still smokes and who suffers from tobacco-related diseases and death. Smoking rates are highest among people with lower income and less education, those who are uninsured or on Medicaid, American Indians/Alaska Natives, residents of the Midwest and South, LGBTQ Americans, and adults who regularly had feelings of anxiety or depression. In addition, the tobacco industry’s long history of targeting Black Americans with marketing for menthol cigarettes – and resulting high rates of menthol smoking among Black Americans – has had a devastating impact. The evidence is clear that menthol makes it easier for kids to start smoking and harder for smokers to quit. Black Americans quit smoking at lower rates and die at high rates from smoking-related diseases like lung cancer, heart disease and stroke.

The Health Equity and Accountability Act requires comprehensive tobacco cessation coverage for all Medicaid beneficiaries without cost sharing or preauthorization. These services include individual, group and telephone counseling, as well as seven FDA-approved medications. While states have made progress in providing cessation coverage under Medicaid, only 19 states currently cover all available treatments and only 3 states cover all treatments without any barriers to access.

Comprehensive Medicaid coverage of tobacco cessation services is critical as Medicaid beneficiaries smoke at more than twice the rate of those with private insurance. It is also cost-effective as Medicaid spends more than $68 billion a year on health care for smoking-related diseases. Importantly, the bill provides needed funding to allow states to conduct outreach campaigns to educate Medicaid beneficiaries about the program.

After Massachusetts provided comprehensive Medicaid coverage of smoking cessation services in 2006 and conducted an outreach campaign to raise awareness of the benefit, the smoking rate among beneficiaries declined by 26 percent in the first 2.5 years. The state dramatically reduced hospitalizations for heart attacks and cardiovascular disease among Medicaid recipients, saving more than $3 for every $1 spent on cessation services, studies have shown.

In addition, the bill doubles the cigarette excise tax and creates tax parity for other tobacco products. Raising the price of tobacco products is one of the most effective ways to reduce tobacco use, especially among price-sensitive kids. 

We applaud Rep. Kelly and her colleagues for their leadership in tackling the enormous problem of health disparities at this critical time, including disparities caused by tobacco use. This legislation will improve health and save lives