The Impact of Medicaid Family Planning Expansions on Preventive Services Utilization

Objectives. This paper examines the impact of state expansions in eligibility for Medicaid family planning services on the utilization of women's preventive care.

Methods. I examine the effect of the expansions on the use of Pap tests, clinical breast exams (CBEs), HIV testing and routine doctor check-ups among women ages 21-44 using the Behavioral Risk Factor Surveillance System (1993-2009). I use variation in eligibility for the expansions across states, time and household income level to identify the effect of the policy on utilization. Results. Among women eligible for services, I find a 3% increase in the receipt of a Pap test within the last three years and a 3% increase in the receipt of a CBE under the expansions. Women eligible for Medicaid are less likely to use preventive care than higher income women but the expansions narrowed the gap in service use by 1/5th for CBEs and 1/3rd for Pap tests. I find no change in HIV testing or routine check-ups under the expansions.

Conclusions. Recommended breast and cervical cancer screenings increased among low-income women under state expansions for Medicaid family planning services.