Helping Tobacco Users Quit Act
Sponsored By: Senator Lisa Blunt Rochester
Introduced
Summary
Provides free, comprehensive tobacco cessation coverage for Medicaid and CHIP enrollees. The bill would also temporarily raise the federal matching rate to 90% for these cessation services and related outreach for five years.
Show full summary
- Families and children on CHIP would get counseling and pharmacotherapy for tobacco cessation with no cost-sharing, and CHIP plans could not require prior authorization for those drugs.
- People on Medicaid who use tobacco would gain coverage of diagnostic, counseling, therapy, and pharmacotherapy services delivered under medical supervision and aligned with evidence-based guidelines, with no cost-sharing.
- States would receive a 90% Federal Medical Assistance Percentage for counseling, pharmacotherapy, and outreach costs for a five-year period and would be required to monitor and promote use of cessation services.
- The bill would prohibit prior authorization for tobacco cessation drugs in Medicaid and CHIP and allow qualified licensed health professionals to furnish cessation services under the specified guidelines.
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Bill Overview
Analyzed Economic Effects
5 provisions identified: 5 benefits, 0 costs, 0 mixed.
More CHIP help to quit tobacco
If enacted, State child health plans (CHIP) would have to cover counseling and FDA‑approved drugs to help enrollees quit tobacco. For five years the federal government would pay 90% of qualifying CHIP counseling and pharmacotherapy costs, and 90% of outreach campaign costs. Any payment received under this rule would increase the State's CHIP allotment for that fiscal year.
More Medicaid cessation coverage and funding
If enacted, State Medicaid plans would have to cover counseling and FDA‑approved drugs to help enrollees quit tobacco. For five years the federal government would pay 90% of state spending on those counseling services and drugs. States would also get 90% reimbursement for outreach to raise awareness and must describe how they will monitor and promote these services. Extra FMAP money paid to U.S. territories for this purpose would be ignored when applying territorial caps.
No cost sharing for quit services
If enacted, Medicaid and CHIP plans could not charge deductibles, coinsurance, or other cost sharing for counseling, therapy, or covered drugs used to help people quit tobacco. The bill would also add these services and related covered outpatient drugs to the list treated under alternative cost‑sharing exception rules. States could still limit over‑the‑counter drugs generally, but must cover FDA‑approved over‑the‑counter cessation drugs when the guideline recommends them.
No prior authorization for cessation drugs
If enacted, Medicaid and CHIP plans could not require prior authorization before covering prescription or covered outpatient drugs used to help people quit tobacco. States could not use prior authorization to limit access to FDA‑approved cessation drugs.
Start date and minors' coverage protection
If enacted, the bill's Medicaid and CHIP changes would start on the first day of the first fiscal year after enactment. Nothing in the bill could be read to limit counseling or drugs for people under 18.
Sponsors & CoSponsors
Sponsor
Lisa Blunt Rochester
DE • D
Cosponsors
Angela Alsobrooks
MD • D
Sponsored 8/1/2025
Roll Call Votes
No roll call votes available for this bill.
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