Lori Berman brings back bill to cap the cost of breast exams for state employees

TALLAHASSEE, FLA. 4/20/22-Sen. Lori Berman, D-Boynton Beach, speaks against the congressional redistricting map the Senate later approved, Wednesday at the Capitol in Tallahassee. COLIN HACKLEY PHOTO

Every year, tens of thousands of women in Florida receive life-threatening breast cancer diagnoses.

And that doesn’t include those unaware they have the disease because testing is too costly.

Sen. Lori Berman is working to eliminate such cases among state employees.

The Boynton Beach Democrat filed legislation this week (SB 158) to expand coverage for diagnostic and supplemental breast examinations, without cost-sharing, for women enrolled in Florida’s state group insurance program.

“It says if you go in for a mammogram and you need to have a supplemental exam, like an MRI or an ultrasound, that they can only charge you the same copay they charged you for the mammogram,” Berman, a breast cancer survivor, told Florida Politics.

“Right now, we encourage people to get mammograms by keeping their copays at a low or nonexistent number. But then when they’re told, ‘OK, now you need to go to the next step,’ they’re all of a sudden faced with a big charge. A lot of the time they don’t follow through. And because of that, they don’t get diagnosed early, if at all, which can lead to fatal results.”

In 2024 alone, an estimated 23,160 patients in Florida were diagnosed with breast cancer and 3,160 died from it, according to the American Cancer Association.

A study commissioned by the nonprofit Susan G. Komen Foundation 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. 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.

Susan Harbin, senior government relations director for the American Cancer Society’s Cancer Action Network, said patients have a more than 90% survival rate when they’re diagnosed early and the cancer is still localized.

“A lot of times patients encounter these out-of-pocket costs that are a barrier to treatment, and we know that an even three-month delay in treatment can lead to a later-stage diagnosis,” she said during talks on the issue last year.

Many state governments have taken steps to lower the cost barrier. By July 10, 2024, Komen said more than 20 states in the U.S. had enacted legislation to cap or eliminate cost-sharing for diagnostic and supplemental breast imaging.

Berman carried a similar proposal during the 2024 Legislative Session. It passed unanimously in the Senate, but its House companion — sponsored by Hollywood Rep. Marie Woodson, a fellow Democrat — died in its last committee stop.

“I’m very hopeful that this year it will pass,” Berman said. “We want people to be able to get diagnosed, and this bill sets it up so that they will not have to pay an exorbitant amount for these supplemental examinations.”

The 2025 Legislative Session commences March 4 and runs through May 2.