Health Equity and Accountability Act of 2024 Addresses Glaring Health Disparities, Including Those Caused by Tobacco

Health Equity and Accountability Act of 2024 Addresses Glaring Health Disparities, Including Those Caused by Tobacco

Statement of Yolonda C. Richardson, President and CEO, Campaign for Tobacco-Free Kids
July 25, 2024

WASHINGTON, D.C. - The Campaign for Tobacco-Free Kids applauds U.S. Senator Mazie Hirono (D-HI) and Representatives Barbara Lee (D-CA) and Judy Chu (D-CA), Chair of the Congressional Asian Pacific American Caucus, for introducing the Health Equity and Accountability Act of 2024, which provides a comprehensive strategy for addressing health disparities in the United States, including disparities caused by tobacco use. Among other things, this legislation would significantly increase tobacco taxes and expand coverage for tobacco cessation services under Medicaid, CHIP and private health plans, which are proven strategies to reduce tobacco use and the death and disease it causes.

The Congressional Asian Pacific American Caucus (CAPAC), with strong support from the Congressional Black Caucus and Congressional Hispanic Caucus, is leading the introduction of this legislation, and Senator Hirono and Congresswoman Lee (CAPAC Health Task Force co-chair) are the lead sponsors.

While the U.S. has made enormous progress in reducing smoking, there are large disparities in who still smokes and who suffers from tobacco-related diseases and death. Smoking rates are highest among people with lower income and less education, those who are uninsured or on Medicaid, American Indians/Alaska Natives, residents of the Midwest and South, LGBTQ Americans, and adults who regularly had feelings of anxiety or depression. Cigarette smoking is a major cause of cancer, heart disease and stroke, all of which are leading causes of death among the Asian American, Native Hawaiian and Pacific Islander (AANHPI), Black and Hispanic populations. In addition, the tobacco industry's long history of targeting Black Americans with marketing for menthol cigarettes - and the resulting high rates of menthol smoking and tobacco-related diseases among Black Americans - has had a devastating impact. One of the many strengths of this legislation is that it recognizes the need for culturally appropriate health care and cessation programs.

The Health Equity and Accountability Act requires comprehensive tobacco cessation coverage for all Medicaid and CHIP beneficiaries without cost sharing. These services include individual, group and telephone counseling, as well as seven FDA-approved medications. The bill also prevents prior authorization requirements for tobacco cessation medications. While states have made progress in providing cessation coverage under Medicaid, only 22 states currently cover all available treatments and only 4 states cover all treatments without any barriers to access.

Comprehensive Medicaid coverage of tobacco cessation services is critical as Medicaid beneficiaries smoke at more than twice the rate of those with private insurance. It is also cost-effective as Medicaid spends more than $72 billion a year on health care for smoking-related diseases. Importantly, the bill provides needed funding to allow states to conduct outreach campaigns to educate Medicaid beneficiaries about the program.

In addition, the bill doubles the cigarette excise tax and creates tax parity for other tobacco products. Raising the price of tobacco products is one of the most effective ways to reduce tobacco use, especially among price-sensitive kids.

We applaud Senator Hirono and Representatives Lee and Chu for their leadership in tackling the enormous problem of health disparities at this critical time, including disparities caused by tobacco use. This legislation will improve health and save lives.