United States: A law to address health inequalities

On October 7, 2020, Democratic U.S. Senator Mazie Hirono and eight of her colleagues announced their intention to introduce the “ Health Equity and Accountability Act 2020 »[1], which provides a comprehensive strategy to address health disparities in the United States, including disparities caused by tobacco.

Eliminating health and tobacco disparities across the country

The Health Equity and Accountability Act (HEAA - Health Equity and Accountability Act) aims to reduce health disparities. Racial and ethnic minorities, the LGBTQ+ community, rural populations and socioeconomically disadvantaged communities (people without health insurance or Medicaid beneficiaries), and women more generally are less well protected in terms of health in the United States. The HEAA proposes policy solutions aimed at greater health equity, including the issue of inequalities related to tobacco.

Indeed, the United States has made significant progress in reducing tobacco use. However, there are disparities across states and also disparities across the communities and groups discussed above that are major targets for the tobacco industry. This initiative comes at a critical time as the COVID-19 pandemic continues to disproportionately harm vulnerable populations and puts smokers at greater risk of complications.

The Importance of Integrating Smoking Cessation into the Medicaid Program

The Health Equity and Accountability Act would significantly increase tobacco taxes. It would also provide comprehensive coverage for tobacco treatment for Medicaid beneficiaries, with no out-of-pocket costs or prescriptions. These services include individual, group, and telephone counseling, as well as prescription drug coverage for seven drugs approved by the U.S. Food and Drug Administration. Such Medicaid coverage is critical because tobacco use is twice as high among Medicaid beneficiaries as among those with private insurance. Importantly, the bill provides funding for states to conduct prevention education campaigns among Medicaid enrollees.

Investments deemed necessary and which have proven their worthsee

On June 22, 2020, Rep. Lisa Blunt Rochester (D-Del.)[2], supported by several American health organizations, had also introduced legislation " Quit Because of COVID-19 Act » which aims to extend smoking cessation support to all Medicaid beneficiaries during the COVID-19 crisis.

Massachusetts' experience with providing comprehensive coverage for tobacco dependence treatment through Medicaid shows that the smoking rate among program beneficiaries declined from $381,000 to $281,000 over two and a half years. The state significantly reduced hospitalizations for heart attacks and cardiovascular disease among Medicaid enrollees, saving more than $3,000 for every dollar spent on smoking cessation services.[3].