The Helping Tobacco Users Quit Act amends Titles XIX (Medicaid) and XXI (CHIP) of the Social Security Act to significantly expand access to tobacco cessation services. Its primary purpose is to require states to provide comprehensive coverage for counseling and pharmacotherapy to help individuals quit tobacco use under both programs. This includes diagnostic, therapy, and counseling services, as well as both prescription and nonprescription tobacco cessation agents approved by the Food and Drug Administration. For Medicaid, the bill mandates that states cover these services for all eligible individuals, furnished by physicians or other authorized healthcare professionals in accordance with established clinical guidelines. To encourage state participation, it provides a temporary enhanced Federal Medical Assistance Percentage (FMAP) of 90% for these services for five years. Furthermore, the legislation prohibits states from imposing any cost-sharing, such as deductibles or coinsurance, for these essential tobacco cessation benefits. A key provision for Medicaid also eliminates the requirement for prior authorization for FDA-approved tobacco cessation drugs, streamlining access to treatment. States are also required to monitor and promote the use of these services, including conducting outreach campaigns to raise awareness among eligible individuals and clinicians. The federal government will reimburse states at a 90% rate for the development, implementation, and evaluation of these outreach efforts for a five-year period. Similarly, for the Children's Health Insurance Program (CHIP), the bill mandates coverage of comprehensive tobacco cessation counseling and pharmacotherapy. Like Medicaid, CHIP plans will be prohibited from imposing cost-sharing on these benefits and from requiring prior authorization for tobacco cessation drugs. States must also undertake monitoring and outreach campaigns to promote the use of these services among CHIP beneficiaries and providers. To support these CHIP provisions, the bill provides 90% federal reimbursement for both the cost of furnishing these services and for the associated outreach campaigns for five years. It also includes a rule of construction clarifying that the Act does not limit existing coverage for individuals under 18 years of age. The amendments are set to take effect on the first day of the first fiscal year following the Act's enactment.
Get AI-generated questions to help you understand this bill better
Timeline
Introduced in Senate
Read twice and referred to the Committee on Finance.
Introduced in Senate
Read twice and referred to the Committee on Finance.
Health
Helping Tobacco Users Quit Act
USA119th CongressS-2064| Senate
| Updated: 6/12/2025
The Helping Tobacco Users Quit Act amends Titles XIX (Medicaid) and XXI (CHIP) of the Social Security Act to significantly expand access to tobacco cessation services. Its primary purpose is to require states to provide comprehensive coverage for counseling and pharmacotherapy to help individuals quit tobacco use under both programs. This includes diagnostic, therapy, and counseling services, as well as both prescription and nonprescription tobacco cessation agents approved by the Food and Drug Administration. For Medicaid, the bill mandates that states cover these services for all eligible individuals, furnished by physicians or other authorized healthcare professionals in accordance with established clinical guidelines. To encourage state participation, it provides a temporary enhanced Federal Medical Assistance Percentage (FMAP) of 90% for these services for five years. Furthermore, the legislation prohibits states from imposing any cost-sharing, such as deductibles or coinsurance, for these essential tobacco cessation benefits. A key provision for Medicaid also eliminates the requirement for prior authorization for FDA-approved tobacco cessation drugs, streamlining access to treatment. States are also required to monitor and promote the use of these services, including conducting outreach campaigns to raise awareness among eligible individuals and clinicians. The federal government will reimburse states at a 90% rate for the development, implementation, and evaluation of these outreach efforts for a five-year period. Similarly, for the Children's Health Insurance Program (CHIP), the bill mandates coverage of comprehensive tobacco cessation counseling and pharmacotherapy. Like Medicaid, CHIP plans will be prohibited from imposing cost-sharing on these benefits and from requiring prior authorization for tobacco cessation drugs. States must also undertake monitoring and outreach campaigns to promote the use of these services among CHIP beneficiaries and providers. To support these CHIP provisions, the bill provides 90% federal reimbursement for both the cost of furnishing these services and for the associated outreach campaigns for five years. It also includes a rule of construction clarifying that the Act does not limit existing coverage for individuals under 18 years of age. The amendments are set to take effect on the first day of the first fiscal year following the Act's enactment.