Sen. Leland Yee, the Democrat from San Francisco, has introduced legislation to require health plans and health insurers to provide tobacco cessation counseling and medication to their customers with little or no cost-sharing.
Yee argues that counseling and medication have proven to be “one of the most clinically effective and cost-effective” health services available, up to 80 times more effective than drugs prescribed (and paid for by insurance) to prevent heart attacks. He says that more than 70 percent of smokers wish they could quite and half try every year. But the success rate remains less than 5 percent. Access to counseling and medication, he contends, doubles that quit rate and has in some cases achieved rates as high as 25 to 30 percent. Access to these serves would save $4 for every $1 invested, Yee claims.
But these benefits are not necessarily cost effective for insurers because people change plans so often. One company might pay for the services but then see that customer go elsewhere, while customers who smoke and have not had the services come onto that firm’s role. For that reason, Yee says, a universal mandate makes sense.
The bill, SB 220, would require the plans and insurers to provide over-the-counter drugs with no co-pays. Prescription drugs and and tobacco counseling that would include up to two courses per year would come with a co-pay of no more than $15.
Health insurers and health plans generally argue that mandates such as these add to the cost of coverage for everyone, even when they require the plans to pay for cost-effective prevention measures.
See the full bill here.
Photo by wlodi.
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