Effects of State Cervical Cancer Insurance Mandates on Pap Test Rates.

<bold>Objective: </bold>To evaluate the effects of state insurance mandates requiring insurance plans to cover Pap tests, the standard screening for cervical cancer that is recommended for nearly all adult women.<bold>Data Sources: </bold>Individual-level data on 600,000 women age 19-64 from the CDC's Behavioral Risk Factor Surveillance System.<bold>Study Design: </bold>Twenty-four states adopted state mandates requiring private insurers in the state to cover Pap tests from 1988 to 2000. We performed a difference-in-differences analysis comparing within-state changes in Pap test rates before and after adoption of a mandate, controlling for the associated changes in other states that did not adopt a mandate.<bold>Principal Findings: </bold>Difference-in-differences estimates indicated that the Pap test mandates significantly increased past 2-year cervical cancer screenings by 1.3 percentage points, with larger effects for Hispanic and non-Hispanic white women. These effects are plausibly concentrated among insured women.<bold>Conclusions: </bold>Mandating more generous insurance coverage for even inexpensive, routine services with already high utilization rates such as Pap tests can significantly further increase utilization. [ABSTRACT FROM AUTHOR]