title: Clinicians' awareness of the Affordable Care Act mandate to provide comprehensive tobacco cessation treatment for pregnant women covered by Medicaid.
abstract: The Affordable Care Act (ACA) requires states to provide tobacco-cessation services without cost-sharing for pregnant traditional Medicaid-beneficiaries effective October 2010. It is unknown the extent to which obstetricians-gynecologists are aware of the Medicaid tobacco-cessation benefit. We sought to examine the awareness of the Medicaid tobacco-cessation benefit in a national sample of obstetricians-gynecologists and assessed whether reimbursement would influence their tobacco cessation practice. In 2012, a survey was administered to a national stratified-random sample of obstetricians-gynecologists (n = 252) regarding awareness of the Medicaid tobacco-cessation benefit. Results were stratified by the percentage of pregnant Medicaid patients. Chi-squared tests (p < 0.05) were used to assess significant associations. Analyses were conducted in 2014. Eighty-three percent of respondents were unaware of the benefit. Lack of awareness increased as the percentage of pregnant Medicaid patients in their practices decreased (range = 71.9%-96.8%;P= 0.02). One-third (36.1%) of respondents serving pregnant Medicaid patients reported that reimbursement would influence them to increase their cessation services. Four out of five obstetricians-gynecologists surveyed in 2012 were unaware of the ACA provision that required states to provide tobacco cessation coverage for pregnant traditional Medicaid beneficiaries as of October 2010. Broad promotion of the Medicaid tobacco-cessation benefit could reduce treatment barriers.
authors.affiliation: Division of Reproductive Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Van T
authors.initials: VT
authors.lastname: Tong
authors.affiliation: Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Lucinda J
authors.initials: LJ
authors.lastname: England
authors.affiliation: Office on Smoking and Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Ann
authors.initials: A
authors.lastname: Malarcher
authors.affiliation: American College of Obstetricians and Gynecologists, Washington, DC, USA.
authors.forename: Jeanne
authors.initials: J
authors.lastname: Mahoney
authors.affiliation: American College of Obstetricians and Gynecologists, Washington, DC, USA.
authors.forename: Britta
authors.initials: B
authors.lastname: Anderson
authors.affiliation: American College of Obstetricians and Gynecologists, Washington, DC, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Schulkin
keywords: Insurance; Medicaid; Obstetricians–gynecologists; Pregnancy; Smoking cessation