Sponsors (2)
The bill expands and protects access to tobacco‑cessation counseling and medications—especially for Medicaid/CHIP enrollees and minors—and boosts outreach, but does so at appreciable near‑term federal cost and with likely increased program, provider, and longer‑term state budget pressures.
Medicaid and CHIP enrollees (including pregnant women) will gain guaranteed coverage of counseling and FDA‑approved tobacco‑cessation medications, with no prior authorization or cost‑sharing, increasing access to quitting services and likely improving quit rates and health outcomes.
States receive an enhanced 90% federal Medicaid/CHIP match (FMAP) for cessation services and outreach for five years, substantially reducing near‑term state budget burdens for implementing and promoting these benefits.
Minors keep existing or expanded coverage for counseling and pharmacotherapy (the Act preserves enhanced pediatric mental‑health and medication coverage), protecting youth access and preventing rollbacks of benefits.
The five‑year enhanced 90% FMAP significantly increases federal spending over that period, raising federal budget outlays and costs borne by taxpayers.
When the temporary enhanced FMAP expires after five years, states may face substantially higher ongoing costs to maintain expanded cessation benefits and outreach, creating future state budget pressure.
Removing prior authorization and cost‑sharing will likely increase utilization and program costs, shifting administrative and financial burdens to managed care plans, providers, and pharmacies.
Based on analysis of 4 sections of legislative text.
Requires Medicaid and CHIP to cover counseling and FDA‑approved tobacco cessation drugs, bans certain cost‑sharing/prior authorization, and provides a temporary 90% federal match for five years.
Introduced June 12, 2025 by Lisa Blunt Rochester · Last progress June 12, 2025
Requires Medicaid and CHIP to cover counseling and FDA‑approved pharmacotherapy for tobacco cessation for enrollees, bans specified cost‑sharing and prior authorization for those services, and provides a temporary enhanced federal match (90% FMAP) for those cessation services and related outreach for five years. States must monitor and promote comprehensive cessation services to beneficiaries and clinicians, and protections preserve coverage for people under 18.