One of Obamacare’s major approaches to tackling skyrocketing health care costs is by encouraging a healthier citizenry through a combination of healthy-living incentives to doctors and patients and free preventative care services for Americans. Smoking cessation efforts have been a major part of those preventative efforts — and with good reason, since cardiovascular disease is the number one cause of death in America, and localities that engage in aggressive anti-smoking efforts tend to see a substantial return on their investment.
But a recent study by the public health advocacy group Tobacco Free Kids finds that there is a large amount of confusion over the rules governing smoking cessation in qualifying health plans, as Kaiser Health News reports:
[W]hen researchers at Georgetown University’s Health Policy Institute examined 39 health plans in six states, they found that coverage for smoking cessation was often confusing. Many contracts didn’t clearly state that the coverage was available, didn’t cover recommended treatments and/or didn’t provide it without cost-sharing.
“The study points out the need for the Department of Health and Human Services to provide much more specific guidelines,” Myers says.
Insurers offer a different perspective. “The final rules [for preventive services] recognized that there wasn’t necessarily a one-size-fits-all approach,” says Susan Pisano, a spokeswoman for America’s Health Insurance Plans, a trade group. “So we would expect to see variation around the methods that plans are using.” In addition, she said AHIP’s own survey of plans found that nearly all offer some type of intervention for tobacco users.
It isn’t surprising that AHIP is content with the current fragmented coverage. Covering smoking cessation programs as preventative care, without charging Americans a co-pay, ultimately translates into higher costs for the insurance companies that AHIP represents. Fortunately, though, the health care reform law is less interested in guarding insurers’ profits and more interested in reducing Americans’ medical costs by encouraging them to improve their health. So better guidelines should naturally follow.
Especially considering the fact that recent Obamacare rules also allow insurance companies — to an extent — to charge American smokers higher premiums than non-smokers, it would be unfair to Americans if the federal government did not offer clearer guidelines on the preventative services that smokers will receive in return for their health care payments.
The designation of anti-smoking programs as freely available preventative services has also been extended to the seniors on Medicare.