Massachusetts' Success in Helping Medicaid Recipients Quit Smoking Shows Why Congress Should Require Cessation Coverage in Health Reform

Washington, D.C. — Massachusetts today announced extraordinary results from its aggressive efforts to help Medicaid beneficiaries quit smoking by providing easy access to coverage for smoking cessation medication and counseling.

Massachusetts reported that smoking rates among beneficiaries in its MassHealth program plunged by 26 percent in the first two and a half years after the state began providing coverage of smoking cessation in July 2006. Costly medical procedures among those who utilized the cessation benefit also fell dramatically. Among benefit users, there were 38 percent fewer hospitalizations for heart attacks and 17 percent fewer emergency-room visits for asthma symptoms in the first year after using the benefit. There were 17 percent fewer claims for maternal birth complications since the benefit was implemented, state health officials reported.

Massachusetts is leading the way in demonstrating that health insurance coverage for smoking cessation quickly improves health and saves lives, and no doubt reduces health care costs as well. These findings have major implications as Congress debates health care reform. They underscore why Congress should require health care coverage for smoking cessation, including for everyone in Medicaid. The House-passed health reform bill does so, and the Senate should as well. Health care reform should also provide robust funding for community-based prevention initiatives, including tobacco prevention and cessation campaigns that prevent kids from starting to smoke and encourage smokers to quit.

It is also critical that Massachusetts increase funding for its tobacco prevention and cessation programs. As Massachusetts reported today, its new cessation benefit was coupled with an aggressive promotion campaign run by the Massachusetts Tobacco Cessation and Prevention Program that included radio and transit advertising and extensive community outreach. Unfortunately, Massachusetts in the past two years has cut funding for its tobacco prevention and cessation program by 65 percent. Including a federal grant, funding this year is just $6.1 million, which is less than seven percent of the $90 million recommended by the U.S. Centers for Disease Control and Prevention (CDC). To continue reducing tobacco use, Massachusetts must increase funding for tobacco prevention and cessation.

Medicaid coverage of smoking cessation is critical as smoking is much more prevalent among lower-income Americans than in the population as a whole. The CDC reported last week that, in 2008, 31.5 percent of adults living below the federal poverty level smoked, compared to 20.6 percent of all adults. Medicaid costs attributable to smoking total $22 billion annually, and represent 11 percent of all Medicaid expenditures, according to the CDC. Yet, according to another recent CDC study, only six states in 2007 provided the recommended full coverage of all tobacco-dependence treatments (FDA-approved medications and counseling) to help smokers quit.

Tobacco use is the leading preventable cause of death in the United States, killing more than 400,000 Americans and costing $96 billion in health care bills each year. The new Massachusetts results demonstrate once again that we know how to dramatically reduce tobacco use and its devastating toll in health, lives and dollars. What's needed is a political commitment to implement proven solutions, including health care coverage for smoking cessation and aggressive, well-funded tobacco prevention and cessation programs.