Many health insurance plans are failing to provide coverage mandated by the Affordable Care Act for treatments to help smokers and other tobacco users quit, according to a new study conducted by researchers at Georgetown University. The study, commissioned by the Campaign for Tobacco-Free Kids with funding from Pfizer Inc analyzed 39 health insurance plans sold in six states, including individual, small group, federal employee, and state employee plans.
The researchers found that many policies included confusing and conflicting language that could leave consumers uncertain if tobacco cessation treatments were covered and discourage them from seeking these treatments. Moreover, many policies were found to house gaps in the coverage for cessation counseling, medication, and cost-sharing requirements that appear to conflict with the law.
The ACA requires new private health insurance plans to cover preventative health services with either an A or B grade given by the US Preventative Services Task Force (USPSTF). Such services include tobacco cessation treatments, which received an A grade. In addition, these services should be covered with no cost-sharing, i.e. co-pays.
“The Affordable Care Act recognized that coverage for preventative care, including helping people quit tobacco, is a critical part of improving health and reducing health care costs in our country,” said Matthew L. Meyers, president of the Campaign for Tobacco-Free Kids. “Tobacco use is a leading risk factor for cancer, heart and lung disease and other serious chronic conditions. Covering effective tobacco cessation treatments is a smart way for insurers to avoid the cost of future illness, and it is the law. “
