Impact of Health Reform on Smoking and Treatment Utilization
The overall objective of the proposed study is to capitalize on a once in a lifetime opportunity to examine how the implementation of landmark health care legislation has impacted the population of smokers in a private health care delivery system, their treatment utilization, and their smoking cessation outcomes over time. New insured smokers through Medicaid expansion and CA exchanges are likely to be a vulnerable group, with a higher prevalence of comorbidities, and unique barriers to utilization of tobacco treatment. The proposed study is designed to test whether newly insured patients have a higher percentage of comorbidities and differential use of tobacco treatment since key provisions of the Affordable Care Act (ACA) have brought an influx of previously uninsured patients. Further, the study will test whether variation in benefit plan and coverage among post ACA new member smokers differentially impacts tobacco treatment utilization and smoking cessation outcomes longitudinally.