More women getting Pap tests, breast exams under expanded Medicaid family-planning programs

More low-income women are having potentially life-saving health screenings in states with expanded Medicaid eligibility for family planning services, according to new research from the University of Michigan.

The study will be published in the August issue of the American Journal of Public Health.

"When states expand eligibility for family planning under Medicaid, they significantly increase the number of who obtain potentially life-saving Pap tests and breast exams. This is good for women's health and may help states to lower future ," said Laura Wherry, a Robert Wood Johnson Health & Society Scholar at the U-M School of Public Health and a research affiliate at the U-M Institute for Social Research.

Wherry found that the expansions increased the proportion of low-income women receiving a Pap test by 2.8 percentage points and a clinical breast exam by 1.6 percentage points, each within the last year.

On their own, these numbers may not sound high, but when combined with estimates of participation in Medicaid family-planning services under the expansions, they imply a 19 percent increase in Pap-test receipt and an 11 percent increase in clinical breast examinations among women enrolled in the programs, she said.

Additionally, the expansions narrowed the gap between low- and high-income women receiving these exams by 26 percent for the Pap test and 12 percent for breast exams.

The study also looked at HIV-screening and routine checkups, and found little difference in the use of those services.

Expanded family planning under Medicaid is optional, with 31 states currently implementing these programs. Passage of the Affordable Care Act in 2010 made it easier for states to expand access to family planning services by eliminating administrative barriers, Wherry said.

"States that may be considering these programs now have evidence that they increase the use of recommended preventive care," she said.

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