Bill banning out-of-pocket charges for breast imaging could help thousands in Florida

This month, the Historic Capitol building has been lit up pink, part of Breast Cancer Awareness Month. Image via Colin Hackley.

Tens of thousands of Floridians received breast cancer diagnoses in 2023. Some learned of their condition far later than they should have because of how pricey breast imaging can be.

Legislation (SB 932) up for discussion Monday aims to change that. It would prohibit insurers from charging out-of-pocket costs for medically necessary diagnostic and supplemental breast examinations.

Boynton Beach Sen. Lori Berman, the bill’s sponsor, knows firsthand the impact the change would have.

“As an eight-year breast cancer survivor, I am grateful for the treatment I was afforded. As soon as I knew my mammogram revealed a mass that subsequent testing determined was breast cancer, I was able to go forward with a treatment plan. Not everyone has the same means,” she said in a statement.

“Now is the time to add Florida to a growing list of states that have passed this life-saving legislation nationwide.”

Free mammograms are available today, but in cases where an abnormality is detected or the patient has a family history of breast cancer, they’re just the first step. In such cases, doctors must perform diagnostic and supplemental examinations, including MRIs and ultrasounds, to determine the need for a biopsy and additional measures.

More than 22,670 Floridians were diagnosed with breast cancer last year. About 3,170 died of the disease, according to the nonprofit Susan G. Komen, which blames “exorbitant out-of-pocket costs associated with essential breast imaging procedures” as contributing to those figures.

A 2019 study the organization commissioned found that out-of-pocket costs for patients ranged from $234 for a diagnostic mammogram to more than $1,000 for a breast MRI. About 12% of women screened with modern digital mammography require follow-up imaging or biopsy, according to the American Cancer Society. But alarmingly, the Komen study revealed that 1 in 5 patients are likely to forgo recommended follow-up imaging if they have to pay a deductible.

The good news is that since the study’s publication, many states have passed laws similar to SB 932 and its House companion (HB 773) by Hollywood Rep. Marie Woodson. That includes close to a dozen states, Georgia and Tennessee among them, which passed laws last year, according to an American College of Radiology overview.

“As someone who has benefitted from early detection, I cannot stress how impactful and important this legislation is,” Woodson said in a statement. “Breast cancer is a life-or-death situation, and breaking the barriers to accessing care is paramount.”

Berman and Woodson’s legislation has a solid chance of success. Senate President Kathleen Passidomo made clear ahead of Session that expanding access to free health screenings and primary care was at the top of her to-do list.

It’s also a personal issue for Gov. Ron DeSantis, who spoke often while on the presidential campaign trail about his wife, Casey’s, battle with breast cancer.

If passed, the proposed change would be effective July 1 for covered state employees. For all other Floridians, it would apply to health insurance policies on or after Jan. 1, 2025.

A Senate staff analysis determined the change would cost Florida $3.6 million more per year in increased state health plan claims.

Berman’s bill is scheduled to be heard at the 1:30 p.m. Senate Banking Insurance Committee meeting on Jan. 29, after which it would have two more panels to clear before reaching a floor vote.

Woodson’s bill awaits a hearing at the first of three of three committees to which House Speaker Paul Renner referred it last month.