State-level Medicaid expenditures attributable to smoking

Area of Science:

• Public Health
• Health Economics
• Tobacco Control

Background:

• Medicaid recipients exhibit higher smoking rates (53% above general population).
• Tobacco use leads to significant disease burden among this demographic.

Purpose of the Study:

• To estimate state-level Medicaid expenditures attributable to smoking.
• To quantify the economic impact of smoking on the Medicaid program.

Main Methods:

• Utilized state and national data with a 4-part econometric model.
• Calculated smoking-attributable fractions of Medicaid spending.
• Multiplied fractions by state Medicaid expenditure data (CMS).

Main Results:

• Nationwide, 11.0% of Medicaid expenditures were smoking-attributable (CI: 0.4%-17.0%).
• Total national smoking-attributable Medicaid expenditures reached $22 billion in 2004.
• State expenditures ranged from $40 million (Wyoming) to $3.3 billion (New York).

Conclusions:

• Cigarette smoking constitutes a substantial portion of annual state Medicaid costs.
• Recommends free/low-cost cessation services for Medicaid enrollees.
• Aims to reduce smoking prevalence and associated healthcare spending.