WASHINGTON – U.S. Senators Dick Durbin (D-IL) and Edward Kennedy (D-MA) joined U.S. Representatives Diana DeGette (D-CO-1) and Todd Platts (R-PA-19) today in introducing companion pieces of legislation in the Senate and the House that provide Medicare and Medicaid coverage to 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 nearly $100 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.

“Despite the known dangers of tobacco use, more than 45 million adults in the United States smoke cigarettes,” said Senator Durbin.  “While nicotine is a highly addictive drug, research has confirmed that tobacco cessation treatment that includes counseling and FDA-approved therapies are extremely effective, both in terms of health improvement and cost savings.  And with more than four in five smokers reporting that they want to quit, there is no excuse for not providing them with the resources to do so.”

“This legislation will help millions of smokers overcome their addiction to nicotine by providing them access to tobacco cessation programs,” said Senator Kennedy, Chairman of the Health, Education, Labor and Pensions Committee. “Most smokers want to quit and they deserve our help.  This bill makes an important investment in a healthier America.”

“Tobacco cessation treatment saves lives and saves money in health costs,” said U.S. Rep. DeGette, Vice Chair of the Committee on Energy and Commerce. “Public health experts recommend that all health insurance plans should cover smoking cessation programs.  This bipartisan legislation leads the way by providing coverage for tobacco cessation treatments with proven effectiveness 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 U.S. Rep. 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 clinical 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.

•     Makes coverage of prescription drugs for tobacco cessation medications mandatory for states that offer prescription drug coverage under Medicaid by eliminating the optional exclusion that exists for tobacco cessation drugs.

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.