Obamacare: The Single Most Important Anti-Smoking Initiative

Michael Hiltzik (Los Angeles Times)

by Desertflower

Did you know that the Affordable Care Act may be the single most important anti-smoking initiative in the country?

Of course not. That’s because Obamacare’s supposed friends, the Democrats, have been too craven to talk about its benefits, while its enemies, the Republicans, want only to depict it as a “disaster” without addressing its many provisions.

“If the ACA’s tobacco-cessation provisions are fully implemented, they could turn out to be one of its greatest legacies.”

– Tim McAfee, et al, New England Journal of Medicine

But the New England Journal of Medicine in its latest issue sets the record straight. The authors, from the Centers for Disease Control and Prevention and the University of Wisconsin, point out that the poor uptake of smoking cessation programs has much to do with their expense and the only spotty coverage by health insurance plans. They say ACA makes this coverage mandatory, without co-pays, cost sharing, or the requirement that doctors get prior authorization from insurers before prescribing. (See accompanying graphic.)

The anti-smoking initiative is just one of many provisions of the ACA that are little-known but likely to have a significant impact on Americans’ health. That underscores the fatuousness of much of the anti-Obamacare campaign. When Senate Majority Leader Mitch McConnell, R-Ky., expresses glee at the prospect that the Supreme Court may yet “take down” the law because he doesn’t like anything that has President Obama’s name on it, these are the babies he’s willing to throw out with the bathwater.

Under the ACA, the NEJM authors write, smoking cessation must be treated as one of the preventive services that private health plans are required to cover without cost-sharing or prior authorization.

THIS INFURIATES ME!! Not this wonderful provision, but the glee at which people like McConnell and other Republicans hope that this signature and historic achievement for the American people, gets gutted! FOLLOW THE FUCKING MONEY….these RWNJ’s care nothing about people. they never did. Never will. They care about money and access and greed…and sucking every last breath from ordinary people just so they can have even MORE! Because to them, this is a win/lose game. If you win, THEY LOSE…and we can’t have that now, can we? Rather than we all want the best for ALL Americans, they don’t subscribe to this. Not even close.

Why do I say this? What the blue fucking blazes set ME off?? I was a smoker. I smoked for 38 years of my life and i loved it and hated it. I was killing myself slowly and I felt guilty as sin for forking over more and more murder money for the tobacco company every time I wanted to feed my addiction. I knew it was bad..I wanted to stop but I was so afraid…thinking of how hard it would be…or gaining some weight…or, or, or…the days went to weeks, weeks to months, months to years and I somehow excused myself. I was a “polite” smoker. Never in my car. Never in the house, Never around those that didn’t smoke. There were never ashtrays all over the place, overflowing with the cancerous remains….I was a one ashtray girl and cleaned up after myself. In fact, I got so good at this deceit, that most people had no idea I smoked at all. But I knew. I was ashamed and embarrassed to be so beholden to this toxic mess. Did you know that these tobacco companies but in things like oven cleaner, DDT and a shit ton of awful, awful stuff. (Cigarette Ingredients)

But look here ( from this piece)

The CDC estimates that about 42 million Americans, or 18% of all adults, are smokers. The highest rate belongs, as it happens, to McConnell’s home state of Kentucky, at 28.3%.

The ACA takes special aim at the Medicaid population. That’s wise, because smoking in the U.S. is especially prevalent among lower-income groups. The law makes no-fee smoking cessation programs and medications a part of Medicaid for new enrollees in those states that have accepted Medicaid expansion, prohibits states from excluding smoking medications from traditional Medicaid, and requires smoking cessation coverage for pregnant women in traditional Medicaid. That’s key, because 20% of pregnant women on Medicaid use tobacco, according to a 2012 study by researchers from UC Berkeley and UC San Diego.

Mitch McConnell would be SO FINE with the people of KY continuing to kill themselves! Continuing to give the tobacco companies money they really don’t have to spend….THIS is what makes me livid!

I have to tell you what made me stop. My son. My son and the perfect storm of his pleading and my readiness to take responsibility for my health and no longer making excuses. I need to tell you something else. It wasn’t hard. After 38 years…it wasn’t hard. I chose to vape my way off nicotine for good and I literally weaned myself off nicotine in about 3 months. None of the side effects that we all worry about…just relief and me being proud of myself and feeling better than anyone can imagine.

So when I see just how far these people (I use that term loosely) would go to have this all go away, AND BE HAPPY ABOUT IT! I want to scream.

America needs to Wake Up…those that feel “guilty” for voting for Republicans because they ” always have”…need to take a cold shower, admit they fucked up badly, and vow to be smarter and more aware in 2 more years. This is UNSAT. Unsatisfactory. Unacceptable. Unfuckingbelieveable that people could ever take pleasure in other people’s pain or want to keep them doing the very things that hurt them and not let them be better or flourish for the rest of their good long lives.

THIS is what pissed me off tonight. That these people hate this President and the American people SO MUCH, they would hope for the demise of something that would help people stop smoking.

If this doesn’t anger you into stopping, into thinking, into honest evaluation of so many things….I don’t know what will. This says they care NOTHING about you.

Your move.

154 Responses to “Obamacare: The Single Most Important Anti-Smoking Initiative”

  1. January 4, 2015 at 10:10 am

    Absolutely outstanding Desertflower, I missed this comment when you posted it, so HUGE thanks to Nerdy for making a post out of it.

  2. January 4, 2015 at 10:14 am

    DF – excellent that this piece of brilliance is front page on TOD. Off it goes to Facebook. NW – always on it, thank you! Have a full moon day! (Well, not until tonight)

  3. 9 amk for obama
    January 4, 2015 at 10:18 am

    that frigging kenyan !!!!!!

    / sd an ex-smoker

  4. 10 desertflower
    January 4, 2015 at 10:20 am

    OMG! I’m so surprised and honored to have this place here to say my piece. Thank you so much, Chips and Nerdy. Truly. The fact that the ACA makes it possible for smoking cessation to be covered, and these people want to make this just go away…made me livid! What kind of monstrous, self serving person DOES THIS??
    If my rant reaches others and has an impact, that’s all I care about. People are wonderfully touched and helped by this historic legislation in ways too numerous to count. Thank you, President Obama…..thank you, Chips and Nerdy. Raise your voices, America! They’re just not that into you!

    • January 4, 2015 at 10:24 am

      “Raise your voices, America! They’re just not that into you!”

      DF, if you were in charge of the mid-terms’ campaign, PBO would now have an entire damn Congress right behind him!!

      Excellent post, you said it ALL!

    • 12 Nerdy Wonka
      January 4, 2015 at 12:04 pm

      Thanks, DF and thanks so much for your powerful personal anecdote.

      ObamaCare is changing millions of lives for the better and thank you for showing us one more way it does so.

      • 13 desertflower
        January 4, 2015 at 12:25 pm

        A pleasure, Nerdy:) Thank you for posting this here so that others can read the LATimes piece. My rant is secondary.

    • January 4, 2015 at 12:36 pm

      Thank you, again, for all the messages you conveyed in that exceptional comment, df. So pleased that NW featured it.

    • January 4, 2015 at 1:09 pm


      i spoke to my grandson..this morning after reading your essay…he has been trying to stop smoking…i told him about the smoke cessation programs under ObamaCare….i encouraged him to move forward and to use the tools that are available…i told him that i would be following up with him next week…he is only 24…but i am proud that he trying to manage the issues in his life… i love that boy…oops young man…as he told me…I’m not a boy anymore grandmom…i just hugged him and smiled..

  5. January 4, 2015 at 10:24 am

    Kudos to you, DF. I smoked for 30 years, quit in 2000 because I too hated being a captive of the toxicity, expense, and arrogance of the industry- any industry for that matter. I tried a couple methods, but not the patch. I figured if I had to shell out that kind of money to quit, I’d just as well hit somebody to release the tension…..LOL….so I cold-turkeyed. It was the best way. Of course, many do not share this resolve, as witnessed even by our president, so cessation programs are a God-send to them. If folks like Mitch can’t find it in what is supposed to represent a heart, then may ill befall/them him instead of his ignorant-ass constituents.

  6. 19 a4alice
    January 4, 2015 at 10:28 am

    Wonderful and TRUTHFUL rant DF! tweeted and extolled others to read. I hope you get a large number of reads! 🙂

  7. January 4, 2015 at 10:33 am

    BRAVA df! This should be required reading.

    Meet the press won’t report on this anti-smoking initiative, but they will repeat every crap from the GOP about wanting to repeal the ACA.

  8. 21 vcprezofan2
    January 4, 2015 at 10:35 am

    Congrats on mastering that particular thorn, Desertf. I bet your son, and daughter, are so proud of you!

    Congrats to the others in the village who have managed to overcome smoking and words of encouragement to those planning to join them in 2015!

  9. January 4, 2015 at 10:36 am

    What a powerful, articulate and worthy commentary, @desertflower ! Both the thoughtful words on smoking and ending its grip on our lives and health, and your poignant and fiesty words about the shocking lack of compassion and presence of malice, greed, and animus toward our President personally as well as toward the ideas, ideals, and spirit for which he works so hard and so faithfully and so brilliantly every day. I had no idea of this provision which was built in to the ACA with noble purpose, and what a difference that can make to so many of our fellow students here in the Earth School. ObamaCares. Excellent essay.

  10. 23 GGail
    January 4, 2015 at 10:37 am

    Good West Coast morning Chipsticks, NW & TOD family.

    DF, this shows that PBO really cares about the health of everybody!

  11. 34 desertflower
    January 4, 2015 at 10:45 am

    Thank you, family. Blushing here….but this really is so important for others to know…to connect the dots. WE must help connect those dots if need be…the MSM won’t. Republicans won’t. Even Dems that are afraid to voice out loud their support for this (read:coward) won’t share this! Our priorities are skewed.

    • 35 arapaho415
      January 4, 2015 at 11:26 am

      Thank you, DF for your personal, heartfelt experiences, and thank you NW for front-paging DF’s comments. 🙂

      I hope you had the opportunity to view the 6-minute video on N.E.R.D.S. (Native Education Raising Dedicated Students), posted here during the holiday season frenzy.

      I thought I’d remind you, since you’re in a state with one of the highest populations of Native Americans — whose community suffers from the highest suicide rate and lowest college enrollment in the US.

      The ability to meet with peers is so important for adolescents — I hope there’s a N.E.R.D.S. chapter in Arizona. It’s heartwarming to see young people who struggled in school to improve their skills through mentoring and encouragement of other young people.

      Dahkota “Kicking Bear” Brown, Jackson CA, started N.E.R.D.S. when he was in the 8th grade:

    • 37 mtmarilyn
      January 4, 2015 at 11:36 am

      Oh DF, I hadn’t told you how much your rant meant when you first posted it. I have friends who have quit and friends who are trying. I have passed you words on to them.

      I agree with the dem cowards that don’t stand up for what is good for all of us.

      • 38 desertflower
        January 4, 2015 at 11:47 am

        Thank you, mtmarilyn:) I hope that they find the strength within themselves to finally make this the year they quit. Please let me know how they fared. Vaping myself free worked so easily for me…

        • 39 debz
          January 4, 2015 at 12:15 pm

          Your post was very informative, I had no idea the anti smoking initiative was in the ACA. I wonder what else is in the law the media hasn’t told us about.

  12. 40 amk for obama
    January 4, 2015 at 10:51 am

    Image and video hosting by TinyPic

    who knew a new coach could do so much in so short a time.

    Image and video hosting by TinyPic

    ha, ha.

  13. 48 desertflower
    January 4, 2015 at 10:52 am

    More: http://www.tobaccofreekids.org/pressoffice/2012/georgetown/coveragereport.pdf

    In 2010 the Obama Administration and Congress took a major step through the Affordable Care Act
    (ACA) to address the significant human life and financial costs of tobacco use in America by requiring
    insurance companies and employers to cover tobacco cessation treatment. This report focuses on a new
    consumer protection provision under the ACA that requires individual and group health insurance to
    cover these treatments.
    Tobacco use is the leading cause of preventable death in the United States, killing more than 400,000
    Americans and costing the nation $193 billion annually in direct medical costs and productivity losses.
    Nicotine addiction is treatable, and evidence suggests that most smokers (nearly 70 percent) want to quit
    and that covering treatment improves the chances that a person will quit smoking. According to the U.S.
    Public Health Service Clinical Practice Guideline on Treating Tobacco Use and Dependence:
    • Tobacco cessation treatments help people quit smoking.
    • Participation rates for treatment programs are higher when there is no cost-sharing.
    • Combining counseling with tobacco cessation medications is more effective than using one type
    of treatment alone.
    • Quit rates are higher when health insurance covers tobacco cessation treatments.
    Additional studies have looked at the cost of tobacco cessation treatment and the resulting cost savings to
    both private employers and state programs, finding significant short-term and long-term savings.
    The ACA requires all new private health insurance plans to cover services recommended by the U.S.
    Preventive Services Task Force (USPSTF) with no cost-sharing.

    Much more at the link.

  14. 49 desertflower
    January 4, 2015 at 10:58 am

    THIS set me off today. http://www.nbcnews.com/politics/barack-obama/wake-police-shootings-obama-speaks-more-bluntly-about-race-n278616

    “The president has essentially changed his racial rhetoric,” said Paul Butler, a Georgetown Law professor and civil rights expert. “It has evolved from cultural critiques of African-Americans to his actually saying the word ‘racism.'”

    Somebody wasn’t paying attention in 2008…http://www.politico.com/news/stories/0308/9100.html (Entire transcript of PBO speech on race from March 18,2008) Excellent Read.

  15. 50 amk for obama
    January 4, 2015 at 10:59 am

    Phil McNulty

    BBC Sport chief football writer

    Yeovil 0-0 Man Utd

    “The rare sight of Louis van Gaal out of his seat and giving instructions. Wayne Rooney the recipient during a break in play and perhaps a sign of the lack of attacking impact in Manchester United’s game so far.”

  16. January 4, 2015 at 11:01 am

    Hey, dear friends. Just want to thank everyone for their love and support over the last couple of weeks. My brother’s burial was last Friday, complete with military honor guard. It was very moving. I lost it when the soldier handed my niece the flag with the words, “On behalf of the President of the United States….” Some days are really tough but I’m doing my best to put my feet forward each day.

    I’m off for a walk to the Golden Gate Bridge. Here’s to a much brighter and healthy 2015 for us all. XOXO.

  17. 71 donna dem 4 obama
    January 4, 2015 at 11:05 am

    Good Morning TOD

    DF, this is magnificent. I just sent this thread link to the DNC, the DCCC and the DSCC.

    Also, I hope you get to see PBO this week.

    • 72 desertflower
      January 4, 2015 at 11:22 am

      Oh goodness:) Thank you, donna! I hope that I get to see PBO this week, too. I am the Poster Child for all his previous housing help….HAMP and the Hardest Hit Fund $$….love to hear him speak in person!

      • 73 mtmarilyn
        January 4, 2015 at 11:39 am

        Hearing and seeing him in person is something you will always remember. I am so glad I got to see him when he was here in 2008.

      • January 4, 2015 at 1:04 pm

        i got to see PBO when he came to Philly to campaign for Wolf for Gov..(.is it a coincidence that Wolf won….nawwww…:-) )..I was so in awe…i started crying….it was glorious…smilin

  18. 75 amk for obama
    January 4, 2015 at 11:05 am

    from beebs live blog

    Angel Di Maria has the look of a haunted child on the bench.

    ha, ha.

  19. 76 JER
    January 4, 2015 at 11:13 am

    Good Morning Chips and TOD.

  20. January 4, 2015 at 11:14 am

  21. January 4, 2015 at 11:14 am

    Excellent post DF, very powerful & poignant words. I am sure your words will encourage others who like you have been wanting to quit smoking. I have never smoked myself, but have seen many who try over and over again to quit only to fail again and again. So good to know that the ACA has this anti-smoking imitative. President Obama loves us all!!

  22. 83 JER
    January 4, 2015 at 11:15 am

  23. 84 JER
    January 4, 2015 at 11:16 am

  24. 85 Don
    January 4, 2015 at 11:19 am

    Very informative piece, DF, as usual the powers that be are hell bent on destroying the ACA by hook or by crook. I mean seriously, do we even have a Democratic Party? Is there a political party out there that stands by the working class?

    • 86 desertflower
      January 4, 2015 at 11:29 am

      Thank you kindly, Don. Well, I think that this is why people get disillusioned with politics and even more, anything civic minded. People seem to get to Washington and forget very quickly who they work for…and when we don’t hold them accountable for their actions or inaction…you just get what we got. The person that working the hardest for everyone, is the one that’s getting badmouthed by all sides for different reasons. Go figure. People need to Wake Up!

  25. 87 arapaho415
    January 4, 2015 at 11:28 am

    Here’s another story about medicine and Native Americans, this one from Humboldt County CA:

  26. 88 arapaho415
    January 4, 2015 at 11:29 am

    And this cracks me up (haven’t read the Daily Telegraph UK story):

  27. 89 Dudette
    January 4, 2015 at 11:33 am

    Awesome post Nerdy and df!

  28. January 4, 2015 at 11:34 am

  29. 107 GGAIL
    January 4, 2015 at 11:35 am

    John Lewis & Leroy Newt were on FTN. Newt actually said the race problem has been stirred up by PBO and the words he uses regarding race relations 😯 I then hit Mute.

  30. 108 Dudette
    January 4, 2015 at 11:39 am

    More sad news today…

  31. 109 Dudette
    January 4, 2015 at 11:40 am

  32. 110 Dudette
    January 4, 2015 at 11:41 am

  33. January 4, 2015 at 11:42 am

    Good morning TOD folks. Alycee, sorry to read about your health issue. Praying for a safe recovery for you. Great article on anti smokiing. I am especially happy to see the universal attention to pregnant women. It does matter.

  34. 116 Dudette
    January 4, 2015 at 11:43 am

  35. 117 Dudette
    January 4, 2015 at 11:44 am

  36. 118 Dudette
    January 4, 2015 at 11:44 am

  37. 120 Dudette
    January 4, 2015 at 11:45 am

  38. 121 Dudette
    January 4, 2015 at 11:46 am

    Gotta hop. Be back tonight! 🙂

  39. 122 forus50
    January 4, 2015 at 11:48 am

    I can’t stop crying over Stuart Scott passing. The smartest, most genuine sports guy who made the highlights even brighter.

  40. 124 amk for obama
    January 4, 2015 at 11:54 am


    no, not man u, the other one.

  41. 125 amk for obama
    January 4, 2015 at 12:09 pm

    last drop of vsop. #vsad.

  42. 126 Nerdy Wonka
    January 4, 2015 at 12:09 pm

  43. 127 amk for obama
    January 4, 2015 at 12:12 pm

    romancing indian style circa 1960

    gunnite toddys.

    And no, no hope for reds.

  44. January 4, 2015 at 12:13 pm

  45. 130 GGail
    January 4, 2015 at 12:13 pm

    Chips, it’s nail biting time…

  46. January 4, 2015 at 12:15 pm

  47. 132 JER
    January 4, 2015 at 12:16 pm


  48. 140 GGail
    January 4, 2015 at 12:20 pm

    This is maddening! Come on time – run out!!!

  49. 146 amk for obama
    January 4, 2015 at 12:22 pm

    huffpuff, huffpuff. #mufc

  50. 147 donna dem 4 obama
    January 4, 2015 at 12:23 pm

    This is just another one of those WH stories that this family will treasure forever!!!!

    June 9, 2014 “Chief of Staff Denis McDonough came to the Oval Office one afternoon and said to the President, ‘let’s take a walk.’ So they proceeded outside the White House gates to a Starbucks on Pennsylvania Avenue. On the way back, the President stopped to greet street vendor Saied Abedy, who was born in Afghanistan. I later selected this photograph to hang as a ‘jumbo’ print on the walls of the West Wing. Several months later, after the jumbo print had been replaced with a newer photograph, we were tipped off that a White House staff member was giving Mr. Abedy and his family a tour of the West WIng one night. So we retrieved the jumbo print of him and hung it back on the walls of the West Wing. I later heard how emotional his family became when they saw the photograph on their tour.”

    (Official White House Photo by Pete Souza)

    • 148 forus50
      January 4, 2015 at 12:30 pm

      Thanks for sharing Donna, what a great story. I just finished reading “A Thousand Splendid Suns” which makes this feel gesture of good will by POTUS just so much more poignant to me.

    • 149 GGail
      January 4, 2015 at 12:31 pm

      Yes Donna! This was one of my favorite back stories told by Pete. I just love it!!! The family was so touched to see the photo on the wall.

  51. 150 GGail
    January 4, 2015 at 12:24 pm

    Oh Whyyyyyyy!!!!! three more minutes

  52. 153 Nena20409
    January 4, 2015 at 1:11 pm

    Fantastic Post!

  53. January 4, 2015 at 2:42 pm

    Thanks for this post. My mother died of lung cancer. It’s a wicked disease.

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