People at risk of breast cancer in Florida would be shielded from exorbitant costs for follow-up exams if a new bill moving through Senate becomes law.
Sen. Lori Berman of Boynton Beach on Tuesday filed SB 1052. The bill would prohibit health insurance companies and maintenance contracts that provide mammogram, breast imaging and breast ultrasound coverage from charging higher co-payments for follow-up exams than they did for the initial test that prompted a health care provider to recommend further testing.
Berman, a breast cancer survivor, said the bill and similar ones she has sponsored — including one that died in committee last year — sprang from talks with the Susan G. Komen breast cancer foundation.
“This is a personal issue for me,” she told Florida Politics. “A lot of women, when they have mammograms — a pretty significant number are told they need some follow-up treatment, and the follow-up treatment can be fairly expensive. Because of that, they don’t follow up. Then they don’t get diagnosed and treated in an appropriate, early detection manner because of the out-of-pocket costs.”
Breast cancer affects both sexes, but it’s about 100 times more common in females than males.
Dr. Bethany Neill of the Moffitt Cancer Center in Tampa told CBS 12 in December 2019 that out of every 1,000 women screened, 10% will need further screenings. Twenty percent will need biopsies and, of those, five women will have breast cancer.
Berman said the figures she’s working with show 12% of patients who receive annual screening mammograms receive calls back for diagnostic imaging.
“That’s a pretty significant number,” she said. “And a lot of them can’t afford to do that now. So, what this bill says is, whatever you were charged for your mammogram, you can’t be charged any more than that for whatever the follow-up diagnostic screening requires. If you need an MRI — if you need an ultrasound or whatever needs to be done to check and confirm you do or don’t have breast cancer — it would be done at the same price as the mammogram.”
The cost-savings on the patient side speak for themselves. Diagnostic mammograms, on average, cost about $230. For a breast MRI, it’s $1,000.
Most women are diagnosed with breast cancer between the ages of 40 and 50, and the chance of a positive screening increases with age.
“By age 41, one out of 217 women (are diagnosed). By 45, (it’s) one out of 93. By age 50, (it’s) one out of 50,” Dr. Jane Mendez, chief of surgery at the Miami Cancer Institute, told WINK News.
The issue has seen more attention in recent months after the diagnoses of Sen. Tina Polsky and First Lady Casey DeSantis in September and October, respectively.
In July, U.S. Rep. Debbie Wasserman Schultz, also a breast cancer survivor, reintroduced legislation to broaden breast cancer screening access under the Affordable Care Act.
Wasserman Schultz this month joined some 40 federal lawmakers, including U.S. Sen. Amy Klobuchar, who revealed in September that she had recently undergone treatment to combat early-stage breast cancer, to call attention to a nationwide decline in routine breast cancer screening due to the COVID-19 pandemic.
“Any decline in breast cancer screenings means more suffering and heartache for the women and families who battle this deadly disease, and tragically dwindling mammography rates means more of them will die,” Wasserman Schultz said at the time.
Berman said she saw resistance to earlier iterations of her bill but hopes to have more support from both sides of the political aisle this Legislative Session.
“I’ve heard some pushback — ‘Why are we singling out just this class of people with this health problem?’ — but breast cancer is prevalent here in our state, and that’s why I’m singling this class out,” she said. “I’d like every class to be treated in the same manner, but for now my concern — especially with the increase in breast cancer; we saw the Governor’s wife and Sen. Polsky were just diagnosed — it’s really important that we do this bill.”