This Surprising Thing Costs More If You're Poor

Today in unfair news: Quitting smoking costs more if you're poor. One of the advantages of the Affordable Care Act is that all private insurance plans are required to cover smoking cessation treatment at no cost to the patient. But there’s a problem: Medicaid doesn’t have the same requirement. As a result, it’s becoming a lot more expensive for low-income Americans to quit smoking than it is for their middle class counterparts.

According to The Atlantic, a new report from the Centers for Disease Control and Prevention found that in spite of demand for the services — Medicaid beneficiaries have higher smoking rates than the general population — serious barriers like co-pays and limits on the duration of use are preventing those on Medicaid from receiving the treatment they need. For the report, the American Lung Association looked at look at coverage in Medicaid programs between December 31, 2008 and January 31, 2014. Researchers found that although more states increased the number of treatments between those dates, more states also put up more barriers preventing people from accessing those treatments. Here are the highlights:

  • 41 states made changes to the treatments they covered.
  • Of those 41 states, 19 states added treatments without removing others; eight states removed treatments without adding others; and 14 states both added and removed coverage.
  • Meanwhile, 38 states made changes to barriers accessing treatments
  • Of those 38 states, 12 added barriers without removing old ones and 17 both removed and added barriers.
  • Only nine states removed barriers without adding new ones.

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In a word, this sucks. It’s been well-documented that living in poverty is expensive: When you don’t have a car to get to the grocery store, you buy your groceries from the corner store — where everything is more expensive; week-to-week payments for rooms in budget hotels tend to add up over time to more than a regular monthly rent would be; the jobs available don’t pay enough to allow for savings; and so on. This is yet another issue that shows exactly how far we have to go when it comes to class and economic divides in the U.S.

And do you want to know the really crazy thing? Getting rid of barriers and offering more treatments will both save lives and cut costs. Said Tim McAfee, M.D., M.P.H., Director of the CDC’s Office on Smoking and Health, “States can save lives and reduce costs by providing Medicaid coverage for all proven cessation treatments, removing barriers to accessing these treatments, and promoting the expanded coverage.” Makes sense, right? Reducing the number of smokers will result in a healthier population — which means reduced health care costs in the long run.

But at least studies like this one are drawing attention to the problem. Knowing is half the battle, right? Now we just need to do something about it.