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Health Insurance Mandates, Mammography, and Breast Cancer Diagnoses

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  • Marianne P. Bitler
  • Christopher S. Carpenter

Abstract

We examine the effects of state health insurance mandates requiring coverage of screening mammograms. We find evidence that mammography mandates significantly increased mammography screenings by 4.5-25 percent. Effects are larger for women with less than a high school degree in states that ban deductibles, a policy similar to a provision of federal health reform that eliminates cost-sharing for preventive care. We also find that mandates increased detection of early stage in-situ precancers. Finally, we find a substantial proportion of the increased screenings were attributable to mandates that are not consistent with 2014 recommendations of the American Cancer Society.

Suggested Citation

  • Marianne P. Bitler & Christopher S. Carpenter, 2016. "Health Insurance Mandates, Mammography, and Breast Cancer Diagnoses," American Economic Journal: Economic Policy, American Economic Association, vol. 8(3), pages 39-68, August.
    • Handle: RePEc:aea:aejpol:v:8:y:2016:i:3:p:39-68
    Note: DOI: 10.1257/pol.20120298
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    Cited by:

    1. Di Giacomo, Marina & Piacenza, Massimiliano & Siciliani, Luigi & Turati, Gilberto, 2022. "The effect of co-payments on the take-up of prenatal tests," Journal of Health Economics, Elsevier, vol. 81(C).
    2. Zhu, Xinqi & Vrachioli, Maria & Edoardo, Baldoni & M'barek, Robert & Sauer, Johannes, 2021. "Bio-Refineries – a Solution to the EU Sustainable Development Challenges," 2021 Conference, August 17-31, 2021, Virtual 315164, International Association of Agricultural Economists.
    3. Itzik Fadlon & Torben Heien Nielsen, 2019. "Family Health Behaviors," American Economic Review, American Economic Association, vol. 109(9), pages 3162-3191, September.
    4. Price, Sarah & Zhang, Xiaohui & Spencer, Anne, 2020. "Measuring the impact of national guidelines: What methods can be used to uncover time-varying effects for healthcare evaluations?," Social Science & Medicine, Elsevier, vol. 258(C).
    5. Eibich, Peter & Goldzahl, Léontine, 2021. "Does retirement affect secondary preventive care use? Evidence from breast cancer screening," Economics & Human Biology, Elsevier, vol. 43(C).
    6. Liran Einav & Amy Finkelstein & Tamar Oostrom & Abigail Ostriker & Heidi Williams, 2020. "Screening and Selection: The Case of Mammograms," American Economic Review, American Economic Association, vol. 110(12), pages 3836-3870, December.
    7. Scott Barkowski & Joanne Song McLaughlin & Alex Ray, 2020. "A Reevaluation of the Effects of State and ACA Dependent Coverage Mandates on Health Insurance Coverage," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 39(3), pages 629-663, June.
    8. Marianne Bitler & Lucie Schmidt, 2012. "Utilization of Infertility Treatments: The Effects of Insurance Mandates," Demography, Springer;Population Association of America (PAA), vol. 49(1), pages 125-149, February.
    9. Kim, Hyuncheol Bryant & Lee, Sun-mi, 2017. "When public health intervention is not successful: Cost sharing, crowd-out, and selection in Korea's National Cancer Screening Program," Journal of Health Economics, Elsevier, vol. 53(C), pages 100-116.
    10. Shurtz, Ity & Brzezinski, Amnon & Frumkin, Ayala, 2016. "The impact of financing of screening tests on utilization and outcomes: The case of amniocentesis," Journal of Health Economics, Elsevier, vol. 48(C), pages 61-73.
    11. Thomas C. Buchmueller & Léontine Goldzahl, 2018. "The effect of organized breast cancer screening on mammography use: Evidence from France," Health Economics, John Wiley & Sons, Ltd., vol. 27(12), pages 1963-1980, December.
    12. Fabrice Smieliauskas & Hari Sharma & Connor Hurley & Jonas A. de Souza & Ya‐Chen Tina Shih, 2018. "State insurance mandates and off‐label use of chemotherapy," Health Economics, John Wiley & Sons, Ltd., vol. 27(1), pages 55-70, January.
    13. Son, Jinyeong, 2022. "Do mandated health insurance benefits for diabetes save lives?," Journal of Public Economics, Elsevier, vol. 216(C).
    14. Bertoni, M.; Corazzini, L.; Robone, S.;, 2017. "The Good Outcomes of Bad News. A Randomized Field Experiment on Formatting Breast Cancer Screening Invitations," Health, Econometrics and Data Group (HEDG) Working Papers 17/27, HEDG, c/o Department of Economics, University of York.

    More about this item

    JEL classification:

    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • H75 - Public Economics - - State and Local Government; Intergovernmental Relations - - - State and Local Government: Health, Education, and Welfare
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • J16 - Labor and Demographic Economics - - Demographic Economics - - - Economics of Gender; Non-labor Discrimination

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