Bill Will Eliminate Out-Of-Pocket Costs To Patients For Required Tests
Susan G. Komen®, the world’s leading breast cancer organization, today applauded the introduction of the Access to Breast Cancer Diagnostic (ABCD) Act of 2021 in the U.S. House of Representatives, led by Rep. Debbie Dingell (D-MI). The legislation would eliminate out-of-pocket costs for diagnostic tests when a mammogram reveals an abnormality and for those that require diagnostic imaging due to personal and/or family history.
The cost of diagnostic tests, which can include an ultrasound, breast MRI and diagnostic mammogram, can cost patients between $234 and $1,021, according to a Susan G. Komen study. The tests provide doctors a deeper, detailed look at a patient’s breasts to evaluate signs or symptoms of breast cancer to determine if a biopsy to test for cancer is needed.
“It is unacceptable that people must pay hundreds to thousands of dollars, out of pocket, to determine if they have breast cancer. People are struggling right now to afford basic care and will forego pricey additional testing simply because of the cost. This legislation will help make detection more affordable and accessible so that breast cancers are caught early, and more lives can be saved,” said Molly Guthrie, Sr. Director of Public Policy & Advocacy at Susan G. Komen.
Under current law, insurance providers are only required to cover the full cost of annual screening mammograms. Those that are unable to afford the out-of-pocket costs that remain for diagnostic imaging might delay or forego the needed testing. This delay may mean the cancer has time to advance before treatments begin, making it much deadlier and much more costly to treat.
“Cost should never stand in the way of a women getting the diagnostic tests she needs, and early diagnosis saves lives,” said Dingell. “One in eight women will develop breast cancer in her lifetime, and this bipartisan legislation will improve access to early treatment and care.”
Several states have taken action to eliminate the out-of-pocket costs for state regulated plans, including the introduction of bills in more than 15 states. States with legislation already signed into law include Arkansas, Colorado, Illinois, Louisiana, New York and Texas. Passage of the ABCD Act would require federally regulated health plans across the country to cover the full cost of medically necessary diagnostic imaging.
The U.S. Senate has already introduced its version of the legislation.
Systematic use of breast cancer screening and follow-up diagnostic testing has led to important increases in the early detection of breast cancer in the past 30 years. Despite this progress, the COVID-19 pandemic led many to delay or skip breast screenings which could lead to missed diagnoses or increased late-stage diagnoses. To make up for lost progress and to keep progress going, everyone needs affordable access to the diagnostic tests they require.