June 27, 2019

Bipartisan Sponsors Introduce PALS Screening Access Act in Senate

On June 20, Senators Marsha Blackburn (R-TN) and Dianne Feinstein (D-CA) introduced S. 1936, the Protecting Access to Lifesaving Screenings (PALS) Act of 2019, a bill that would postpone controversial recommendations from the U.S. Preventive Services Task Force (USPSTF) that could limit access to breast cancer screening for women in their 40s.

The legislation proposes to continue a moratorium on the USPSTF recommendations, which Congress has extended several times.

The Patient Protection and Affordable Care Act (PPACA) includes provisions to eliminate patient cost sharing requirements as a barrier to accessing lifesaving cancer screens. PPACA requires individual and group (employer) insurance plans to provide certain preventive screening tests, as determined by a variety of agencies and advisory bodies, including the USPSTF, the Centers for Disease Control and Prevention (CDC), and the Health Resources and Services Administration (HRSA), to beneficiaries free of out-of-pocket costs.

In 2009 and as part of a scheduled re-review in 2016, the USPSTF released breast cancer screening guidelines assigning a “C” grade to screening mammography for women age 40–49 years and a “B” recommendation for biennial screening mammography beginning at age 50. This was a significant departure from breast cancer screening guidelines of leading clinical organizations for women’s health — including the American College of Radiology (ACR)/Society for Breast Imaging, National Comprehensive Cancer Network and the American Medical Association. All these groups recommend breast cancer screening beginning annually at age 40 for women of average risk.

If the USPSTF recommendations are recognized for purposes of PPACA coverage mandates, individual and group (employer) insurance plans would no longer be required to cover annual mammography with no cost sharing for millions of women ages 40 to 49.

Blackburn and Feinstein were joined by Senators Shelly Moore Capito (R-WV), Jeanne Shaheen (D-NH), Kirsten Gillibrand (D-NY), Cindy Hyde-Smith (R-MS), Amy Klobuchar (D-MN), Lisa Murkowski (R-AK), Rob Portman (R-OH), Debbie Stabenow (D-MI) and Elizabeth Warren (D-MA) as co-sponsors of S. 1936.

H.R. 2777, the House PALS Act companion bill, was introduced by Representatives Debbie Wasserman-Schultz (D-Fla.) and Susan Brooks (R-Ind.) in the House of Representatives on May 15.

The ACR applauds this effort and will continue to support both the House and Senate bills. We will keep you apprised as the legislation advances.