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Health Insurance Mandates, Mammography, and Breast Cancer Diagnoses
Marianne P Bitler1, Christopher S Carpenter2
1Department of Economics, University of California Davis, 1 Shields Avenue, Davis, CA 95616.
American Economic Journal. Economic Policy
|March 13, 2018
Summary
State health insurance mandates significantly boosted mammography screenings, particularly for women with lower education levels. Increased early-stage cancer detection was observed, though some screenings exceeded current guidelines.
Area of Science:
- Public Health
- Health Policy
- Cancer Screening
Background:
- State health insurance mandates influence healthcare utilization.
- Mammography is a key tool for breast cancer early detection.
- Preventive care access is a focus of health reform.
Purpose of the Study:
- To evaluate the impact of state mammography mandates on screening rates.
- To identify subgroups benefiting most from these mandates.
- To assess alignment of mandated screenings with established guidelines.
Main Methods:
- Analysis of state-level data on mammography screening rates.
- Comparison of screening trends before and after mandate implementation.
- Examination of effects across different demographic groups and state policies.
Main Results:
- Mammography mandates increased screenings by 4.5-25%.
- Mandates showed larger effects for women with less than a high school education in states banning deductibles.
- Increased detection of early-stage in-situ pre-cancers was noted.
Conclusions:
- State mammography mandates are effective in increasing screening rates.
- Policies eliminating cost-sharing enhance mandate effectiveness for vulnerable populations.
- A notable portion of increased screenings may not align with current American Cancer Society recommendations.
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