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Senate Bill 2064S 2064

Helping Tobacco Users Quit Act

Health

18 pages

senate
house
president

Introduced June 12, 2025 by Lisa Blunt Rochester · Last progress June 12, 2025

Bill Summary

Summary

Requires Medicaid and CHIP to cover comprehensive tobacco cessation counseling and FDA‑approved pharmacotherapies for all eligible enrollees, with no cost‑sharing and bans on prior authorization for cessation drugs. Provides a temporary enhanced federal reimbursement (90% FMAP) for state and CHIP spending on these services and on outreach to promote use for five years, and preserves or expands coverage for children and pregnant women.

Key Points

Medicaid and CHIP must cover comprehensive tobacco cessation counseling and FDA‑approved pharmacotherapies for all eligible enrollees.
No cost‑sharing is allowed for cessation counseling or for covered cessation medications.
States may not impose prior authorization requirements for tobacco cessation drugs as a condition of coverage/payment.
Federal reimbursement is increased to 90% for Medicaid and CHIP expenditures on cessation services and related outreach for five years.
States must monitor and promote use of cessation services and may be federally reimbursed to run outreach campaigns.
Enhanced payments to territories are exempted from the territory payment cap.
Changes take effect on the first day of the first fiscal year beginning on or after enactment.
The law explicitly does not reduce or limit existing coverage for minors.

Pros & Cons

The bill expands no‑cost tobacco cessation coverage and speeds access for Medicaid and CHIP enrollees and clarifies pediatric behavioral‑health benefits while using a temporary 90% federal match to lower state costs — but it raises near‑term federal spending, could increase state and program costs when the enhanced match expires, and imposes administrative and legal uncertainties.

Potential Benefits

5

Medicaid beneficiaries and CHIP enrollees (including children and pregnant women) gain comprehensive tobacco cessation counseling and FDA‑approved pharmacotherapies with no cost‑sharing, increasing access to treatment for low‑income and vulnerable populations.
States receive a temporary 90% federal reimbursement (FMAP) for expenditures on tobacco cessation services and outreach for five years, substantially lowering state implementation costs in the near term.
Medicaid and CHIP enrollees get faster, easier access because the bill prohibits prior authorization for FDA‑approved cessation medications and allows coverage of nonprescription FDA‑approved agents.

Potential Drawbacks

5

Taxpayers and the federal budget face higher near‑term spending because of the 90% FMAP for five years, and federal budget pressures could rise again when the enhanced match expires.
State governments and taxpayers may confront higher Medicaid/CHIP pharmacy and program costs if utilization of covered cessation medications (including nonprescription agents) increases, particularly after the temporary enhanced federal match ends.
State Medicaid and CHIP agencies must implement outreach, monitoring, and evaluation activities, creating administrative workloads and short‑term costs for state governments.

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Categories & Tags

Agencies

Department of Health and Human Services (HHS)

Food and Drug Administration (FDA)

Centers for Medicare & Medicaid Services (CMS)

Department of Health and Human Services (Secretary of Health and Human Services)

Subjects

Medicaid & CHIP

Mental Health & Substance Use

Health Insurance Coverage

Commemorative Designations

Prescription Drugs

Maternal & Child Health

+2 more

Affected Groups

Medicaid Beneficiaries

Children & Youth

Pregnant Women

State Governments

+1 more

Sponsors (2)