Sponsors (2)
The bill greatly expands access to evidence‑based tobacco‑cessation services for low‑income populations (including children and pregnant women) and eases state adoption with temporary, generous federal funding — but it increases federal spending, creates implementation burdens, and may raise program costs for states or insurers once the enhanced funding ends.
Medicaid and CHIP enrollees — including low‑income adults, children, and pregnant women — gain covered access to tobacco‑cessation counseling and FDA‑approved pharmacotherapies, increasing access to evidence‑based treatment.
State Medicaid and CHIP programs receive temporary enhanced federal reimbursement (90% FMAP) for five years for cessation services and outreach, reducing state budget pressure for adopting these benefits.
Beneficiaries will face fewer access barriers because the legislation blocks prior authorization requirements for FDA‑approved cessation agents and eliminates deductibles/coinsurance for CHIP cessation services, making it easier and faster to obtain treatment.
Federal taxpayers face higher federal outlays because the 90% reimbursement and outreach matching increase federal Medicaid/CHIP spending and could widen the deficit or require budget offsets.
State governments may incur short‑term administrative burdens and implementation costs (for coverage changes, outreach, and monitoring) despite enhanced federal reimbursement.
Removing prior authorization and forbidding cost‑sharing may increase utilization of cessation services and medications, raising program costs for states or insurers — particularly after the temporary federal funding ends.
Based on analysis of 4 sections of legislative text.
Requires Medicaid and CHIP to cover tobacco cessation counseling and FDA‑approved pharmacotherapy, bans cost‑sharing, and provides 90% federal matching for services and outreach for five years.
Introduced June 12, 2025 by Lisa Blunt Rochester · Last progress June 12, 2025
Requires Medicaid and CHIP to cover comprehensive tobacco cessation services — counseling and FDA‑approved pharmacotherapy — for eligible enrollees, bans cost‑sharing for those services, and funds outreach and promotion. The federal government will pay an enhanced matching rate (90% FMAP) for service delivery and outreach for five years; CHIP receives parallel enhanced reimbursement and added allotment support. The law also prohibits cost sharing and prior authorization for cessation drugs and preserves coverage for minors.