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State Medicaid Coverage for Tobacco-Dependence Treatments-United States, 1994-2002
MMWR Highlights
January 30, 2004 / Vol. 53 / No. 3
Need for Tobacco-Dependence Treatment Among Medicaid Enrollees
Because rates of smoking are highest among people living in poverty, the negative health effects of tobacco use are of major concern for State Medicaid programs.
Medicaid recipients have approximately 50% greater smoking prevalence than the overall U.S. population.
In 2000, approximately 11.5 million (36%) adult Medicaid recipients smoked cigarettes.
Extent of Coverage for Tobacco-Use Treatments In State Medicaid Programs
In 2002, eleven (22%) states offered no coverage for
tobacco-dependence treatment under Medicaid, and only New Jersey and
Oregon provided coverage for all treatment options recommended by the
PHS Clinical Practice Guideline.
The number of Medicaid programs providing some coverage for
counseling or medication increased from 37 (73%) in 2001 to 40 (78%) in
2002.
In 2002, only 16 (31%) states offered some form of tobacco-dependence
counseling services, the primary recommendation for pregnant women.
Only 11 (28%) state Medicaid programs that provided coverage for
tobacco-dependence treatment benefits informed their recipients that
these benefits were available to them.
Of the 40 states that offered any coverage in 2002, all but one
covered at least one pharmacotherapy treatment (i.e., Zybanฎ, nicotine
nasal spray, nicotine inhaler, nicotine patch, or nicotine gum).
Data show that co-payments result in decreased use of treatment;
however, 20 (57%) states required some form of patient cost sharing,
which ranged from $1.00 to $3.00 per prescription.
According to the Public Health Service (PHS) Clinical Practice
Guideline, Treating Tobacco Use and Dependence, treatment with either
counseling or medication doubles quit rates.
The Guide to Community Preventive Services recommends reducing the
cost of tobacco-dependence treatments, especially in low-income
populations, to increase the use of treatment by smokers attempting to
quit and the number of successful quitters.
State Medicaid Coverage for Tobacco-Dependence Treatments-United States, 1994-2002 Full Report
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