Men are getting more screening colonoscopies since the health law reduced how much Medicare beneficiaries pay out of pocket for the preventive tests, a recent study found. The change, however, didn鈥檛 affect women鈥檚 rates.
, published in the December issue of Health Affairs,聽compared聽rates of screening for colorectal cancer among people age 66 to 75 before and after the health law passed in 2010. Starting in 2011, that law waived the (which totals $147 annually in 2015) and eliminated the requirement that beneficiaries pay 20 percent of the cost for screening colonoscopies.
The data came from the Centers for Disease Control and Prevention鈥檚 annual .
The study found that in men, colonoscopy screening rates increased from 18 to聽22 percent following implementation of the health law, a 20 percent increase. In women, however, the rate didn鈥檛 budge, remaining at 18 percent even after the law passed.
The study鈥檚 finding that women didn鈥檛 respond to policy changes related to colorectal cancer screening coverage is consistent with other research, said聽Kandice Kapinos, the study co-author who is an economist at Rand, a nonprofit research and policy organization.
鈥淢aybe they assess their risk differently because they generally have a lower incidence of colorectal cancer than men,鈥 she said.
There is also some research that shows that women are more likely to say an endoscopic screening test such as a colonoscopy is embarrassing and to opt instead for a blood stool screening test, Kapinos said.
Under the health law,聽services that are recommended by the U.S. Preventive Services Task Force are covered without patients having to pay anything out of pocket. The task force recommends using stool testing, sigmoidoscopy or聽colonoscopy between age 50 and 75.
Colorectal cancer is the in cancers that affect both men and women, according to the CDC.聽The colonoscopy is considered highly effective as a screening tool because it can locate polyps, most of which are benign, and remove them before they have a chance to become malignant.
Screening rates are lower than they should be, however, and only 40 percent of adults are up to date, according to the study.
Under the health law, private plans a portion of the cost if, during their screening colonoscopy, a polyp is discovered and removed. That step is considered an integral part of a colonoscopy.
Under Medicare, however, beneficiaries may be charged 20 percent coinsurance in such instances because if a polyp is found, the procedure is then considered diagnostic rather than screening. The researchers note that disparity and suggest the elimination of 鈥渢he remaining difference in cost-sharing between screening and therapeutic colonoscopies could improve screening rates.鈥
The American Cancer Society Cancer Action Network continues to urge Congress to close the loophole, says spokeswoman Alissa Crispino.
Please to send comments or ideas for future topics for the Insuring Your Health column.
