Health plans need to up their game to help smokers quit

A majority of state health insurance marketplace plans do not do enough to provide smokers with the assistance they need to quit, according to a new report from the American Lung Association.

The data in this report was collected between Jan. 15 and Feb. 11, 2015 and reflects findings from both the state and federal marketplaces.

The Affordable Care Act requires marketplace plans to cover tobacco cessation treatments without cost sharing, regardless of whether the state operates its own exchange or uses For the most part, the report found that coverage in state marketplace plans was not consistent with federal requirements that dictate how plans cover all seven Food and Drug Administration (FDA)-approved tobacco cessation medications.

Here's what else the report found:

  • Only 60 plans listed all seven FDA-approved tobacco cessation medications on the formulary with no prior authorization.
  • Of the 252 plans in the federal marketplaces, 101 listed all seven tobacco medications as covered formularies.
  • Of the 96 plans in state-run exchanges, 43 listed all seven tobacco medications as covered formularies.
  • Out of all plans examined, 63 listed all seven tobacco medications and indicated that none had cost sharing.
  • Compliance with tobacco cessation depends on the state. For instance, West Virginia was the only state with all marketplace plans that included the seven tobacco medications on their formularies. In five states, no plans listed all tobacco medications on their formularies.
  • When it comes to providing direct links to their formularies, 82.5 percent of plans in federally facilitated marketplaces did so through the website, while only 57.3 percent of plans in state-run exchanges provided links through their states' webiste.

Insurers and the industry continue to debate how to to cover members who smoke. For instance, last year, insurers were able to raise premiums by 50 percent for smokers, causing their monthly costs to skyrocket to as much as $700. Some saw this as a penalty that could actually lead smokers to skip insurance altogether.

On the other hand, supporters of the tobacco surcharge believe a more expensive premium could help curb smoking rates, FierceHealthPayer previously reported.

For more:
- here's the report (.pdf)