WASHINGTON – U.S. Senator Richard Durbin (D-IL) and U.S. Representatives Diana DeGette (D-CO) and Todd Platts (R-PA) today introduced companion pieces of legislation in the U.S. Senate and U.S. House that provide Medicare and Medicaid coverage for tobacco cessation treatments for senior citizens, people with disabilities and low-income adults.

Each year, tobacco use kills an estimated 438,000 Americans—about 1 in 5 of all deaths in the United States.  Tobacco use costs our nation $96 billion annually in health care expenditures, including an estimated 14 percent of all Medicaid costs.   Tobacco use is a leading cause of pregnancy complications, premature birth, and low birth weight.

“Cigarette smoking is the leading preventable cause of death in the United States,” said Senator Durbin.  “While nicotine is a highly addictive drug, research has confirmed that smoking cessation strategies that include counseling and FDA-approved therapies are extremely effective.  And with 70% of current smokers in the US reporting that they want to quit, there is no excuse for not providing them with the resources to do so.”

“Tobacco cessation medications and counseling have been proven effective at saving lives and at saving money in health costs,” said Congresswoman DeGette. “Public health experts recommend that all health insurance plans should cover smoking cessation programs with proven effectiveness.  This bipartisan legislation leads the way by providing coverage for tobacco cessation through our two major public health insurance programs, Medicare and Medicaid.”

“Reducing tobacco use will eventually save taxpayers millions of dollars in Medicaid and Medicare expenditures for smoking-related health conditions,” said Congressman Platts.  “Addressing this issue head-on will save lives, reduce the public health risks related to second-hand smoking and alleviate a major burden on our health care system.”

Tobacco cessation medications and evidence-based counseling greatly increase the odds of quitting smoking successfully.  Moreover, evidence from rigorous research shows that tobacco cessation treatment is highly cost-effective.  Accordingly, the Institute of Medicine recommends that all health insurance plans should cover effective smoking cessation programs.  However, these treatments are not currently available to many tobacco users who are struggling to quit. 

The companion bills provide Medicare and Medicaid coverage for tobacco cessation treatments with proven effectiveness.  They also define tobacco cessation treatments and anti-tobacco health promotion messages as part of quality services under the Maternal and Child Health Program—a step that is crucial for reducing tobacco use among pregnant women.  The American Cancer Society, the American Heart Association, the American Lung Association, the Campaign for Tobacco-Free Kids, and the Partnership for Prevention support the bills.

Highlights of the bills include

Medicare Coverage:

•    Extends coverage to include counseling for cessation of tobacco use.  Approved counselors include state-licensed practitioners, physicians and other Medicare providers (such as clinical social workers, nurse practitioners and psychologists).

•     Defines non-prescription tobacco cessation agents as covered drugs, if those drugs are prescribed by a doctor or other authorized medical professional. 

•     Requires all prescription drug plan sponsors to provide coverage for tobacco cessation drugs approved by the FDA under Medicare’s prescription drug coverage.   

Medicaid Coverage:

•     Extends Medicaid coverage to include tobacco cessation counseling.

•     Enables states to cover prescription drugs for tobacco cessation under Medicaid by eliminating the exclusion that exists for tobacco cessation drugs that currently exists.

Maternal and Child Health Services Block Grant:

•     Enables states to provide and to assure mothers and children (in particular those with low income or with limited availability of health services) access to tobacco cessation counseling, recommendations regarding drugs and devices that can aid tobacco cessation and programs to stop tobacco use before it starts.