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The research project attempts to estimate the current supply and demand for employer-sponsored health insurance coverage for effective smoking cessation treatments (nicotine replacement therapy, Zyban, behavioral interventions). The current demand for employer-sponsored health insurance coverage for smoking cessation treatments is being conducted by analyzing population data from the 2003 Next Generation California Tobacco Control Alliance survey of a random sample of 608 insured adult Californians. The survey asked questions addressing smoking status, age, gender, marital status and race/ethnicity, if they have school age children living at home, if they are political conservatives, liberals or moderates, if they think that tobacco is an addiction or a habit, and if they think that smoking cessation treatments are effective in helping smokers to quit. Three policy-related questions were also asked including their knowledge if their health plan covers smoking cessation treatments (knowing their coverage), their willingness to pay $3 more toward their health insurance premium each year for coverage of smoking cessation treatments (willingness to pay more), and if they think that health plans and employers should cover smoking cessation treatments in their standard benefit packages (support including coverage as a standard benefit).
Preliminary descriptive analysis has been completed on two samples: 1) non-elderly adult Californians with employer-sponsored health insurance (full sample; n=376); and 2) non-elderly adult California smokers with employer-sponsored health insurance (smoker sample; n=54). For each sample, we have identified the individual characteristics associated with adult Californians with employer-based insurance knowing their coverage for tobacco treatments, willingness to pay more for them, and support for including coverage for them as a standard benefit in health plans and health insurance. We have found that persons who describe their political ideology as “conservative” are less likely to support coverage for tobacco dependence treatments and persons who think smoking is an addiction are more likely to support coverage. In addition, those who support coverage are also more likely to be willing to pay an increased premium. Current smokers, those who think smoking is an addition, those who think the treatments are effective and those who describe their political ideology as “liberal” are also willing to pay a higher premium for coverage. However very few characteristics were associated with knowledge of employer coverage. Current smokers were less likely not to know if their employer offered a smoking cessation program, and those who think treatments are effective were less likely not to know if specific treatments were covered.
The current availability of employer coverage for smoking cessation treatments will be determined by analyzing the 2005 Kaiser/HRET California Health Benefits Survey that is in the field. Due to an error in data collection, the data from 2003 that were promised are not available. The 2005 survey is a random sample of 750 firms in California that offer their employees health insurance benefits. Estimates of coverage rates will be made across all firms and treatments, as well as for specific treatments by three firm size categories, five industry groupings, and type of health plans. The findings will then be compared to coverage rates from the 1999 Kaiser/HRET California Health Benefits Survey to assess trends over the last six years. We expect that coverage rates of smoking cessation treatments will have increased across all firm sizes, industries and types of health plans, but that large firms and HMOs will remain more likely to cover treatments, and the service industry will have the lowest coverage rates. We will also conduct a policy analysis on what our findings from the analysis of the supply and demand for smoking cessation coverage suggest regarding the need for and support or opposition for a state requirement that all HMOs and health insurance plans in California include coverage for effective smoking cessation treatments in the standard benefit packages they sell. |
