text: SECTION 1. SHORT TITLE.
  
      This Act may be cited as the ``Smoke Free Mothers and Babies Act of 
  2006''.
  
  SEC. 2. FINDINGS.
  
      Congress makes the following findings:
              (1) At least 1 out of every 10 pregnant women in the United 
          States smokes, which accounts for over 500,000 births per year.
              (2) Tobacco use during pregnancy causes serious harm to the 
          fetus. Fetal mortality rates are 35 percent higher among 
          pregnant women who smoke than among nonsmokers and the Surgeon 
          General reports that a pregnant woman who smokes is 1.5 to 3.5 
          times more likely than a non-smoker to have a low birth weight 
          baby.
              (3) Studies have found that smoking and exposure to 
          secondhand smoke among pregnant women is a major cause of 
          miscarriage, stillbirths, and sudden infant death syndrome 
          (SIDS).
              (4) Preventing just 1 smoking-related low birth weight baby 
          can save more than $40,000 in health care expenditures.
              (5) For every $1 spent on smoking cessation for pregnant 
          women, an estimated $3 in neonatal intensive care costs could 
          be avoided.
              (6) Such expenditures have a disproportionate impact on 
          Medicaid, with estimates indicating that pregnant women on 
          Medicaid are 2.5 times more likely to smoke than pregnant women 
          not on Medicaid. Smoking-attributable neonatal health care 
          costs are estimated to be $1,400,000,000 to $2,000,000,000 
          annually, and such costs for Medicaid total almost 
          $228,000,000, that is, approximately, $738 per pregnant smoker.
              (7) States this year will collect $21,300,000,000 from the 
          Master Settlement Agreement of November 23, 1998, between 
          participating tobacco manufacturers and Attorneys General of 46 
          States, the District of Columbia, the Commonwealth of Puerto 
          Rico, and 4 territories of the United States, other settlement 
          agreements between companies within the tobacco industry and 
          the States of Mississippi, Florida, Texas, and Minnesota, and 
          tobacco taxes (an increase from $20,000,000,000 in fiscal year 
          2005). States are spending only 2.6 percent of their tobacco 
          revenue on tobacco prevention and cessation.
              (8) Evidence shows that the cuts States have made in 
          tobacco prevention funding since 2002 have slowed or possibly 
          stalled recent declines in youth smoking, putting further 
          progress at risk.
  
  SEC. 3. PROMOTING CESSATION OF TOBACCO USE BY PREGNANT WOMEN UNDER THE 
                MEDICAID PROGRAM.
  
      (a) Requiring Coverage of Counseling and Pharmacotherapy for 
  Cessation of Tobacco Use by Pregnant Women.--Section 1905 of the Social 
  Security Act (42 U.S.C. 1396d(a)(4)) is amended--
              (1) in subsection (a)(4)--
                      (A) by striking ``and'' before ``(C)''; and
                      (B) by inserting before the semicolon at the end 
                  the following new subparagraph: ``; and (D) counseling 
                  and pharmacotherapy for cessation of tobacco use by 
                  pregnant women (as defined in subsection (y))''; and
              (2) by adding at the end the following:
      ``(y)(1) For purposes of this title, the term `counseling and 
  pharmacotherapy for cessation of tobacco use by pregnant women' means 
  diagnostic, therapy, and counseling services and pharmacotherapy 
  (including the coverage of prescription and nonprescription tobacco 
  cessation agents approved by the Food and Drug Administration) for 
  cessation of tobacco use by pregnant women who use tobacco products or 
  who are being treated for tobacco use that is furnished--
              ``(A) by or under the supervision of a physician; or
              ``(B) by any other health care professional who--
                      ``(i) is legally authorized to furnish such 
                  services under State law (or the State regulatory 
                  mechanism provided by State law) of the State in which 
                  the services are furnished; and
                      ``(ii) is authorized to receive payment for other 
                  services under this title or is designated by the 
                  Secretary for this purpose.
      ``(2) Subject to paragraph (3), such term is limited to--
              ``(A) services recommended with respect to pregnant women 
          in `Treating Tobacco Use and Dependence: A Clinical Practice 
          Guideline', published by the Public Health Service in June 
          2000, or any subsequent modification of such Guideline; and
              ``(B) such other services that the Secretary recognizes to 
          be effective for cessation of tobacco use by pregnant women.
      ``(3) Such term shall not include coverage for drugs or biologicals 
  that are not otherwise covered under this title.''.
      (b) Exception From Optional Restriction Under Medicaid Prescription 
  Drug Coverage.--Section 1927(d)(2) of the Social Security Act (42 
  U.S.C. 1396r-8(d)(2)) is amended--
              (1) in subparagraph (E), by inserting before the period at 
          the end the following: ``, except in the case of pregnant women 
          when recommended in accordance with the Guideline referred to 
          in section 1905(y)(2)(A)''; and
              (2) in subparagraph (G), by inserting before the period at 
          the end the following: ``, except, in the case of pregnant 
          women when recommended in accordance with the Guideline 
          referred to in section 1905(y)(2)(A), agents approved by the 
          Food and Drug Administration for purposes of promoting, and 
          when used to promote, tobacco cessation''.
      (c) Removal of Cost-Sharing for Counseling and Pharmacotherapy for 
  Cessation of Tobacco Use by Pregnant Women.--
              (1) General cost sharing limitations.--Section 1916 of the 
          Social Security Act (42 U.S.C. 1396o) is amended in each of 
          subsections (a)(2)(B) and (b)(2)(B) by inserting ``, and 
          counseling and pharmacotherapy for cessation of tobacco use by 
          pregnant women (as defined in section 1905(y)) and covered 
          outpatient drugs (as defined in subsection (k)(2) of section 
          1927 and including nonprescription drugs described in 
          subsection (d)(2) of such section) that are prescribed for 
          purposes of promoting, and when used to promote, tobacco 
          cessation by pregnant women in accordance with the Guideline 
          referred to in section 1905(y)(2)(A)'' after ``complicate the 
          pregnancy''.
              (2) Application to alternative cost sharing.--Section 
          1916A(b)(3)(B)(iii) of such Act (42 U.S.C. 1396o-
          1(b)(3)(B)(iii)) is amended by inserting ``, and counseling and 
          pharmacotherapy for cessation of tobacco use by pregnant women 
          (as defined in section 1905(y))'' after ``complicate the 
          pregnancy''.
      (d) Increased FMAP for Tobacco Cessation Counseling Services and 
  Medications.--The first sentence of section 1905(b) of the Social 
  Security Act (42 U.S.C. 1396d(b)) is amended by inserting the following 
  before the period: ``, or medical assistance for counseling and 
  pharmacotherapy for cessation of tobacco use by pregnant women (as 
  defined in subsection (y)) and for covered outpatient drugs (as defined 
  in subsection (k)(2) of section 1927 and including nonprescription 
  drugs described in subsection (d)(2) of such section) that are 
  prescribed for purposes of promoting, and when used to promote, tobacco 
  cessation by pregnant women in accordance with the Guideline referred 
  to in subsection (y)(2)(A)''.
      (e) Effective Date.--The amendments made by this section shall 
  apply to services furnished on or after the first fiscal year quarter 
  that begins after the date of enactment of this Act.
target: Smoke Free Mothers and Babies Act of 2006 - Amends title XIX (Medicaid) of the Social Security Act to require coverage, without cost-sharing, of counseling and pharmacotherapy for cessation of tobacco use by pregnant women. Provides for an increased federal medical assistance percentage (FMAP) for tobacco cessation counseling services and medications.
feat_title: A bill to amend title XIX of the Social Security Act to encourage States to provide pregnant women enrolled in the Medicaid program with access to comprehensive tobacco cessation services.