Lessons from state mandates of preventive cancer screenings

Wendy Yi Xu, Bryan Dowd, Jean Abraham

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


We use the 1997–2008 Medical Expenditure Panel Survey (MEPS) and variation in the timing of state mandates for coverage of colorectal, cervical, and prostate cancer screenings to investigate the behavioral and financial effects of mandates on privately insured adults. We find that state mandates did not result in increased rates of cancer screening. However, coverage of preventive care, whether mandated or not, moves the cost of care from the consumer’s out-of-pocket expense to the premium, resulting in a cross-subsidy of users of the service by non-users. While some cross-subsidies are intentional, others may be unintentional. We find that users of cancer screening have higher levels of income and education, while non-users tend to be racial minorities, lack a usual source of care, and live in communities with fewer physicians per capita. These results suggest that coverage of preventive care may transfer resources from more advantaged individuals to less advantaged individuals.

Original languageEnglish (US)
Pages (from-to)203-215
Number of pages13
JournalEuropean Journal of Health Economics
Issue number2
StatePublished - Mar 1 2016

Bibliographical note

Publisher Copyright:
© 2015, Springer-Verlag Berlin Heidelberg.


  • Cancer prevention
  • Health care disparities
  • Health insurance regulations
  • Mandated benefits
  • Redistributive effects


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