Pap Smear

Cervical cancer is one of the most successfully treatable cancers when detected early. The U.S. cervical cancer death rate declined by 65% between 1955 and 1992, in large part due to the effectiveness of Pap smear screening, and the death rate continues to decline each year.1 While the CDC’s National Breast and Cervical Cancer Early Detection Program covers pap smears for certain categories of underserved women,2 states can expand access to this key preventive screening by requiring coverage in private insurance.

Health plans are required to cover, without copayments, the preventive services recommended by the United States Preventive Services Task Force (USPSTF), including cervical cancer screenings. This provision took effect in September 2010. Additionally, the list of free required preventive services will be updated in 2011 to ensure that services women in particular need are included. "Grandfathered" plans--those that existed before the Affordable Care Act was passed--are exempt from this requirement, but plans will lose their grandfathered status if they significantly cut benefits, increase out-of-pocket spending, or change insurance carriers.

Does the state require private insurers to cover annual Pap smears and cervical cancer screening?

States that require private insurers to cover annual Pap smears receive a "meets policy."  States receive a "weak policy" if they only require insurers to offer coverage of Pap smears as a benefit in health insurance plans, but have not required that it be a covered benefit in insurance plans.  States that do not require insurers to cover annual Pap smears receive a "no policy."

Requirements apply to MCOs and large group market (50+ employees) only.

State Strength of Policy Change from 2007
Alabama No Policy Same
Alaska Meets Policy Same
Arizona No Policy Same
Arkansas No Policy Same
California Meets Policy Same
Colorado No Policy Same
Connecticut No Policy Same
Delaware Meets Policy Same
District of Columbia Meets Policy Same
Florida No Policy Same
Georgia 3 Meets Policy Same
Hawaii No Policy Same
Idaho No Policy Same
Illinois Meets Policy Same
Indiana No Policy Same
Iowa No Policy Same
Kansas Meets Policy Same
Kentucky Meets Policy Same
Louisiana Meets Policy Same
Maine Meets Policy Same
Maryland No Policy Same
Massachusetts Meets Policy Same
Michigan No Policy Same
Minnesota Meets Policy Same
Mississippi No Policy Same
Missouri Meets Policy Same
Montana No Policy Same
Nebraska No Policy Same
Nevada Meets Policy Same
New Hampshire No Policy Same
New Jersey Meets Policy Same
New Mexico Meets Policy Same
New York Meets Policy Same
North Carolina 4 Meets Policy Same
North Dakota No Policy Same
Ohio Meets Policy Same
Oklahoma Meets Policy Better
Oregon Meets Policy Same
Pennsylvania Meets Policy Same
Rhode Island Meets Policy Same
South Carolina Meets Policy Same
South Dakota No Policy Same
Tennessee 5 Weak Policy Same
Texas Meets Policy Same
Utah No Policy Same
Vermont No Policy Same
Virginia Meets Policy Same
Washington No Policy Same
West Virginia Meets Policy Same
Wisconsin No Policy Same
Wyoming Meets Policy Same

Policy Indicator Counts
Meets Policy: 
28
Limited Policy: 
0
Weak Policy: 
1
No/Harmful Policy: 
22
Better: 
1
Same: 
50
Worse: 
0

Data Sources: 1) The Henry J. Kaiser Family Foundation, "State Mandated Benefits: Cancer Screening for Women, 2008," available at http://www.statehealthfacts.org/comparetable.jsp?ind=488&cat=7&sub=114&y..., accessed September 8, 2010; 2) Susan S. Laudicina et al, State Legislative Healthcare and Insurance Issues: 2009

Footnotes

1 American Cancer Society, “ Cervical Cancer: Prevention and Early Detection,” undated, available at http://www.cancer.org/docroot/CRI/content/CRI_2_6X_Cervical_Cancer_Preve..., accessed September 21, 2010.

2 “An estimated 8%–11% of U.S. women of screening age are eligible to receive NBCCEDP services. Federal guidelines establish an eligibility baseline to direct services to uninsured and underinsured women at or below 250% of federal poverty level; ages 18–64 for cervical screening; ages 40–64 for breast screening.” U.S. Department of Health and Human Services, National Center for Chronic Disease Prevention and Health Promotion “National Breast and Cervical Cancer Early Detection Program: About the Program,” December 3, 2009, available at http://www.cdc.gov/cancer/nbccedp/about.htm, accessed September 21, 2010.

3 Georgia was graded incorrectly in the 2007 Report Card.  It should have received a "meets policy" instead of a "no policy." Since there is no change in the individual state law for this state, the comparison with 2007 is based on the underlying data, that is, there is no change from 2007.

4 North Carolina was graded incorrectly in the 2007 Report Card.  It should have received a "meets policy" instead of a "no policy." Since there is no change in the individual state law for this state, the comparison with 2007 is based on the underlying data, that is, there is no change from 2007.

5 Tennessee was graded incorrectly in the 2007 Report Card.  It should have received a "weak policy" instead of a "no policy." Since there is no change in the individual state law for this state, the comparison with 2007 is based on the underlying data, that is, there is no change from 2007.

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