Health Politics

Smokers could have an easier time kicking the habit thanks to a measure passed by the Kentucky General Assembly this week.

Though insurance companies already offer aids including nicotine patches, the bill would prevent insurers from charging co-pays, requiring prior authorization or step therapy — a program that encourages the use of the least expensive drug before moving onto more costly drugs — to gain access.

The legislation now awaits Gov. Bevin’s signature.

Kentucky has one of the highest rates of smoking in the country, a cost of $1.9 billion a year to the health care system. That includes $590 million in Medicaid according to Tonya Chang, advocacy director with the American Heart Association.

Chang said the requirements insurers were using are not backed by research.

“I’m not aware of any science that supports step therapy in smoking cessation,” Chang said. “Those treatment decisions are best left in the hands of doctors.”

The legislation, sponsored by Republican Senator Julie Raque Adams of Louisville, would remove those requirements that are recommended by the United States Preventative Services Task Force.

Smoking cessation benefits became a requirement of coverage for exchange plans when the Affordable Care Act, also known as Obamacare was passed. Most employers and Medicaid plans also offer them.

However, if current legislation in Congress passes, the bill may not benefit as many people.

The GOP-led American Health Care Act, also being touted as Ryancare and TrumpCare, would eventually stop paying Kentucky and other states money for Medicaid expansion beneficiaries. That would mean while Kentucky could keep coverage for people up to 138 percent of the poverty limit, it would be up to the state to foot the bill.

The Congressional Budget Office this week said that compared with current law, under the Republican replacement plan 14 million more people would be uninsured by 2018, and 24 million more would be uninsured by 2026. So, the fewer the people with coverage, the fewer who have access to smoking cessation aids.

Chang with the American Heart Association said their focus is now on increasing the cigarette tax. It is currently 60 cents. In order to see a decline in smoking rates, the tax would have to be raised to $1.60, according to an October report from the journal Health Affairs.

The AHA and other public health groups also targeted a smoke-free schools bill that would have banned smoking on public school property. That bill did not pass the General Assembly.