Health Insurance Mandates, Mammography, and Breast Cancer Diagnoses

Am Econ J Econ Policy. 2016 Aug;8(3):39-68. doi: 10.1257/pol.20120298.

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 pre-cancers. Finally, we find a substantial proportion of the increased screenings were attributable to mandates that are not consistent with current recommendations of the American Cancer Society.

Keywords: breast cancer; insurance mandates; mammography; quasi-experiment.