Who Pays the High Health Costs of Older Workers? Evidence from Prostate Cancer Screening Mandates

Abstract: Between 1992 and 2009, 30 US states adopted laws mandating that health insurance plans cover screenings for prostate cancer. Because prostate cancer screenings are used almost exclusively by men over age 50, these mandates raise the cost of insuring older men relative to other groups. This paper uses a triple-difference empirical strategy to take advantage of this quasi-random natural experiment in raising the cost of employing older workers. Using IPUMS data from the March Supplement of the Current Population Survey, this paper finds that the increased cost of insuring older workers results in their receiving 2.8% lower hourly wages, being 2% less likely to be employed, and being 0.7% less likely to have employer-sponsored health insurance. Between 1992 and 2009, 30 US states adopted laws mandating that health insurance plans cover screenings for prostate cancer. Because prostate cancer screenings are used almost exclusively by men over age 50, these mandates raise the cost of insuring older men relative to other groups. This paper uses a triple-difference empirical strategy to take advantage of this quasi-random natural experiment in raising the cost of employing older workers. Using IPUMS data from the March Supplement of the Current Population Survey, this paper finds that the increased cost of insuring older workers results in their receiving 2.8% lower hourly wages, being 2% less likely to be employed, and being 0.7% less likely to have employer-sponsored health insurance.