Medicaid Expansions and Cervical Cancer Screening for Low-Income Women

Objective. Medicaid coverage for low-income women may play an important role in ensuring access to preventive care. This study examines how Medicaid eligibility expansions to nonelderly adults impact cervical cancer screening among low-income women. Data Sources. We use data from the Behavioral Risk Factor Surveillance System from 2000 to 2010. The primary outcome of interest is whether women in the relevant guideline consistent age range reported having a Pap test in the previous year. Study Design. We use a difference-indifferences approach with matched treatment and comparison states and a simulated eligibility approach based on a continuous measure of Medicaid generosity. Principal Findings. Our results indicate that cervical cancer screening increased among low-income women in expansion states relative to comparison states. Increases in screening rates are largest among low-income Hispanic women. Conclusions. Medicaid expansions during the period from 2000 to 2010 were associated with improved cervical cancer screening rates, which is critical for early cervical cancer detection and prevention of cancer morbidity and mortality in women. The results suggest that more widespread Medicaid expansions may have positive effects on preventive health care for women. Key Words. Medicaid, insurance, cervical cancer, screening, prevention
Among U.S. women, there are over 4,000 deaths from cervical cancer each year (American Cancer Society 2016), despite the fact that the disease could be practically eliminated with screening and [...]