Effects of State Cervical Cancer Insurance Mandates on Pap Test Rates

Cervical cancer is one of the most preventable, treatable, and survivable cancers, and nearly all adult women are recommended to have had a Pap test (the standard screening for cervical cancer).  We provide the first evidence on the effects of 24 state mandates adopted from 1988 to 2000 that require insurance plans to cover Pap tests.  In standard difference-in-differences models using data on 600,000 women age 19-64 from the CDC's Behavioral Risk Factor Surveillance System, we find that these mandates significantly reduced the share of never-screened women by 16 percent.  These effects are plausibly concentrated among insured women and are not observed for other women's health outcomes (e.g., mammograms).  Effects are particularly large, positive, and robust for Hispanic women.  Our results suggest that mandating more generous insurance coverage for even cheap, routine services with already high utilization rates can significantly further increase utilization.