Lawmakers in 4 states introduce bills requiring insurers to cover supplemental breast imaging
Lawmakers in four states recently introduced legislation requiring health insurers to cover supplemental breast imaging.
Those include Florida, New Hampshire, Vermont and Virginia, with thousands of patients standing to benefit from the proposals, according to the Susan G. Komen organization. In Florida alone last year, nearly 23,000 individuals were diagnosed with breast cancer and almost 3,200 died of the disease. “Exorbitant” out-of-pocket costs are often forcing women to skip breast MRIs and other lifesaving procedures.
“Nobody should have to forego a test that helps to rule out breast cancer or confirm the need for a biopsy because of the cost, yet thousands of people in Florida are doing it every year,” Molly Guthrie, VP of policy and advocacy at Dallas-based Susan G. Komen, said in a Jan. 9 announcement. “This bill will provide pivotal access to diagnostic and supplemental imaging so that individuals can get the care they need without having to endure undue financial burden.”
Bills introduced in all four states would eliminate any patient out-of-pocket costs for medically necessary diagnostic and supplemental imaging. This would include MRIs, ultrasounds and diagnostic mammograms, Susan G. Komen noted. About 12% of patients are called back for additional imaging after an abnormal screening. Yet, breast MRIs can cost a patient more than $1,000, frequently deterring them from following through.
“It is heartbreaking when women sacrifice their own health to afford putting food on the table and paying bills,” Virginia Delegate Shelly Simonds said in a separate announcement. “This legislation will remove those barriers to care and will save lives.”
About 20 states have passed legislation bolstering insurance coverage for supplemental breast imaging, including several in 2023. Members of U.S. Congress also have introduced the Find It Early Act, which would require all public and private payers across the nation to cover supplemental breast imaging.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.