The Impact of Near‐Universal Insurance Coverage on Breast and Cervical Cancer Screening: Evidence from Massachusetts

Sabik, Lindsay M.

doi:10.1002/hec.3159

Cited by 36 publications

(31 citation statements)

References 33 publications

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“…While some studies found that access to insurance increased cancer screening, others found that the impact of insurance on cancer screening and detection varied by tumor site or the length of follow-up after a policy change (Han, Zang Xiong, Kramer, & Jemal, 2016;Kolstad & Kowalski, 2012;Robbins et al, 2015;Sabik & Bradley, 2016;Soni, Simon, Cawley, & Sabik, 2017). The Oregon Health Insurance Experiment, a randomized expansion of Medicaid insurance, found that insurance increased cancer screening, but cancer detection and outcomes were not assessed (Baicker et al, 2013;Conlin, Allen, Tsui, Carlson, & Li, 2016).…”

Section: Comparison With the Literaturementioning

confidence: 99%

Does Medicare Coverage Improve Cancer Detection and Mortality Outcomes?

Myerson¹,

Tucker-Seeley²,

Goldman³

et al. 2019

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Medicare is the largest government insurance program in the United States, providing coverage for over 60 million people in 2018. This paper analyzes the effects of Medicare insurance on health for a group of people in urgent need of medical care-people with cancer. We used a regression discontinuity design to assess impacts of near-universal Medicare insurance at age 65 on cancer detection and outcomes, using population-based cancer registries and vital statistics data. Our analysis focused on the three tumor sites with recommended screening before and after age 65: breast, colorectal, and lung cancer. At age 65, cancer detection increased by 72 per 100,000 population among women and 33 per 100,000 population among men; cancer mortality also decreased by 9 per 100,000 population for women but did not significantly change for men. In a placebo check, we found no comparable changes at age 65 in Canada. This study provides the first evidence to our knowledge that near-universal access to Medicare at age 65 is associated with improvements in population-level cancer mortality, and provides new evidence on the differences in the impact of health insurance by gender.

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Section: Comparison With the Literaturementioning

confidence: 99%

Does Medicare Coverage Improve Cancer Detection and Mortality Outcomes?

Myerson¹,

Tucker-Seeley²,

Goldman³

et al. 2019

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“…As in previous studies on mammography use (Bitler & Carpenter, 2016a, 2016bCarrieri & Wuebker, 2016;Pletscher, 2017;Sabik & Bradley, 2016) our dependent variables are based on self-reports. In the first two waves, the ESPS asks women whether they ever had a mammogram.…”

Section: Data: the Enquête Santé Et Protection Socialementioning

confidence: 99%

“…Busch and Duchovny (2005) and Finkelstein et al (2012) find a positive effect of Medicaid. Several recent studies examine the effect of Massachusetts's 2006 health reform on mammography use and obtain mixed results(Keating et al, 2013;Kolstad & Kowalski, 2012;Sabik & Bradley, 2016).3 In addition to France, the Netherlands extends the target age range to 74. In Ireland and Estonia, the upper age limit is 64 and 65, respectively.…”

mentioning

confidence: 99%

The effect of organized breast cancer screening on mammography use: Evidence from France

Buchmueller

Goldzahl

2018

Health Economics

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In 2004, France introduced a national program of organized breast cancer screening. The national program built on preexisting local programs in some, but not all, départements. Using data from multiple waves of a nationally representative biennial survey of the French population, we estimate the effect of organized screening on the percentage of women obtaining a mammogram. The analysis uses difference-in-differences methods to exploit the fact that the program was targeted at women in a specific age group: 50 to 74 years old. We find that organized screening significantly raised mammography rates among women in the target age range. Just above the lower age threshold, the percentage of women reporting that they had a mammogram in the past 2 years increased by over 10 percentage points after the national program went into effect. Mammography rates increased even more among women in their 60s. Estimated effects are particularly large for women with less education and lower incomes, suggesting that France's organized screening program has reduced socioeconomic disparities in access to mammography.

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“…There is limited evidence regarding the effects of public insurance coverage expansions to the nonelderly on cervical cancer screening. Evidence from insurance expansions under Massachusetts health reform shows significant increases in Pap tests, particularly among low‐income women (Sabik and Bradley ). Two studies that consider the effects of Medicaid expansions specifically also find significant positive effects.…”

Section: Introductionmentioning

confidence: 99%

“…This may be attributable to the program's limited budget and uninsured women's lack of awareness of program benefits. In contrast, evidence from coverage expansions under Massachusetts health reform suggests that near‐universal coverage increases cancer screening, indicating an impact of comprehensive coverage beyond that of safety net programs in existence prior to expansion (Sabik and Bradley ). We hypothesize that full Medicaid coverage that may promote engagement with the health care and link women to primary care will increase use of preventive services such as cervical cancer screening, despite the presence of the family planning and NBCCEDP programs.…”

mentioning

confidence: 99%