February 14, 2019

States Consider Expanding Breast Cancer Screening Coverage

The American College of Radiology is working with its state chapters to support legislative and regulatory efforts to minimize the cost and maximize access to breast cancer screening. Several states have introduced legislation to expand mandated insurance coverage to younger women and special populations as described below.

Connecticut

Connecticut has several bills in both the state senate and house. Bills HB 5119, HB 5429, and HB 5214 would require health insurance coverage for annual mammograms for women with a personal or family history of breast cancer and are 30 or older. HB 5047 would expand coverage to include diagnostic mammograms for women who have been diagnosed with breast cancer. HB 6513 would prohibit charging a copayment, cost-sharing, applying to a deductible, or charging of a facility fee for both routine and baseline mammograms for breast cancer screening. In the state senate, SB 626 would require providers to lower the costs of providing mammograms, breast ultrasounds and magnetic resonance imaging of the breast.

Hawaii

Companion bills introduced by Rep. Linda E. Ichiyama, HB 1087 and Sen. Laura Thielen, SB 1043 would require health insurers to provide insurance coverage for breast cancer screenings.

Illinois

Sen. Linda Holmes introduced SB 162. It would require insurance coverage of screening by low-dose mammography for all women 35 or older. Coverage would specifically include: a baseline mammogram for women 35 to 39, an annual mammogram for women 40 or older, a mammogram at the age and intervals considered medically necessary by the woman's health care provider for women under 40 with a family or personal history of breast cancer, prior personal history of breast cancer, and a diagnostic mammogram when medically necessary.

Nebraska

Nebraska’s Sen. Anna Wishart introduced LB 498, a bill that would require coverage for breast cancer screening.

New Jersey

Before stepping down from the New Jersey State Assembly on February 15, then Assemblyman Vincent Prieto introduced AB 478, a bill that would require coverage for mammograms for women under 40 who lack access to family medical history due to their or their parent’s adoption.

New York

State Sen. Kevin S. Parker introduced SB 2596. It would lower the eligibility age for an annual mammogram from 40 to 30 years and lower the eligibility age for a single baseline mammogram from 35 to 25.

Pennsylvania

In Pennsylvania, Rep. Maria Donatucci introduced HB 419, legislation that would amend the Pennsylvania Breast and Cervical Cancer Early Screening Act and expand the age eligibility for breast cancer screening services from 40-49 years to 30–65 years.

Texas

Texas’ Rep. Diego Bernal introduced HB 170. It would require health benefit plans that provide coverage for a screening mammogram provide equal coverage for a diagnostic mammogram.