Stop Smoking with Obamacare

Posted on Jan 14, 2013 by Ailee Slater (G+)

It's the middle of January, which means you should be well on your way to achieving that New Year's resolution; by now, you're running daily, cutting out all saturated fats and spending no more than 20 minutes per day browsing Facebook. Or maybe, like thousands of other Americans, you've made one of the most common New Year's resolutions in the country: quit smoking.

When it comes to smoking, we all know the statistics. In her 2012 report, the U.S. Surgeon General wrote that every day, 1,200 Americans die because of smoking while at the same time two young people become addicted daily. Smokers die on average 13 years earlier than nonsmokers, what with tobacco use leading to heart disease, lung disease and stroke, and complicating treatment for a plethora of other illnesses. But even with dire numbers such as these, it's somewhat of a relief to hear the Centers for Disease Control and Prevention report that a whopping 69 percent of smokers want to quit. To help Americans win this struggle with tobacco, Obama's Affordable Care Act took important steps in supporting smokers who wish to quit.

Obamacare began by defining stop-smoking services as preventative care, which makes sense - quitting smoking is a great way to prevent health problems. Because preventative services must be fully covered by all new insurance plans, stop-smoking treatment is also offered to consumers at absolutely no cost. The Centers for Disease Control and Prevention have found that smokers are much more likely to seek treatment when such care is offered for free, and the legislators behind Obamacare seem to have taken this advisory to heart. Stop-smoking treatment offered for free under Obamacare includes nicotine replacement therapy (NRT), otherwise known as products that give a former smoker nicotine without the cigarette. Nicotine gum, lozenges, nasal sprays and skin patches all fall under this category. Although there is evidence on both sides as to the long term effectiveness of NRT, the Centers for Disease Control does report an overall benefit of nicotine replacements for those people trying to give up cigarettes. Of course, one disadvantage to NRT is the cost - many people attempt to stop smoking in order to save money, however the high price of replacement products offers no net benefit. Clearly, then, the Affordable Care Act's offer of free NRT to quitters will be of great benefit to public health.

Counseling is another key stop-smoking treatment, wherein a quitter meets alone or in a group with a specialist trained to ease the process of cessation. A counselor can help to set a quitting date, create coping mechanisms, and confront situations wherein a quitter may be tempted to start tobacco again. The U.S. Preventative Services Task Force recommends that those trying to stop smoking engage in both nicotine replacement therapy as well as counseling for best results. Lucky for quitters, Obamacare agrees - according to the Affordable Care Act, private health insurance plans must cover services recommended Task Force, such as a combination of NRT and counseling, at no cost to the consumer. All in all, it sounds like Obamacare has done great things to help Americans stop smoking, right? Not quite.

The Affordable Care Act was passed more than two years ago, but in November 2012 a study conducted by Georgetown University found that new insurance plans were not following Obamacare regulations when it came to stop-smoking services. Precisely none of the 39 insurance plans examined clearly stated that the policy would pay for stop-smoking treatments, or that treatment could be accessed with no cost-sharing and no need for a prerequisite like visiting a doctor first. While some of the insurance contracts did allude to tobacco-related services, 26 of the plans didn't mention smoking treatments at all, and some plans were found to have listed stop-smoking care under a category of services not covered by the insurance plan.

The Georgetown study, funded by the Campaign for Tobacco-Free-Kids, recommends that government regulators issue better rules to insurance providers. For example, policies should be required to clearly state the types of stop-smoking treatments covered, and indicate that these treatments will be provided at no cost to the consumer. Consumers should also be informed by their insurers about the availability for coverage of over the counter drugs such as nicotine patches or lozenges, and given basic information about how to access stop-smoking services. It sounds like a lot of work for an insurance company; after all, their job is to provide insurance, not act as healthcare educator to their consumers. Then again, when considering the healthcare costs that quitting smoking can help avoid, it becomes clear why insurance companies should have a huge interest in encouraging customers to stop smoking.

The Centers for Disease Control estimates that tobacco use costs the United States around $193 billion dollars annually, thanks to losses in productivity as well as healthcare expenditures. Smokers usually pay 14 percent more in health insurance premiums, and yet still act as a drain on the policy when considering the health risks that go along with smoking. When less people smoke, everyone benefits, and that includes health insurers. Georgetown and the Campaign for Tobacco-Free-Kids feel that if insurance plans can offer better clarity and information about stop-smoking services, it will be a win for both consumer and health insurance provider in terms of cost and health. Recognizing the importance of stop-smoking treatments, Obamacare even included the provision that smokers enrolled in a stop-smoking program can avoid paying higher insurance premiums. With the Georgetown study hot off the presses, it's fair to say that Obamacare advocates may need a little time to work out how exactly to tackle the issue of insurance companies not offering the stop-smoking services they should.

By 2018, when all existing as well as new insurance plans will be required to offer cost-free preventative services, we can only hope that stop-smoking treatments will be accessible and cheap, and well on their way to making cigarette addiction a thing of the past.