Gabrielle Russon
The Legislature has passed a bill (SB 158) making it more affordable for state employees to get follow-up breast cancer exams.
The House approved the legislation unanimously, with a vote of 116-0.
“Just think about the men and women who cannot afford to come up with the out-of-pocket costs. What happens?” said Democratic Rep. Marie Woodson, who sponsored the House bill. “The cancer starts moving from a stage zero to 1, to 2, to 3, and then it’s too late. In the state of Florida, people should not have to die of breast cancer, because technology is so advanced.”
The Senate bill was sponsored by Sen. Lori Berman, the new Senate Democratic leader, and proposes to eliminate extra out-of-pocket costs for diagnostic and supplemental breast exams for state employees.
The bill would waive additional copays, deductibles and other cost-sharing requirements if patients need to get follow-up appointments. Lawmakers hope those changes will encourage people to continue getting tested.
“The legislation does not seek to create a new coverage mandate. It simply addresses the patient cost-sharing requirements,” said Woodson, who told lawmakers the issue was personal to her.
Her mother was diagnosed with breast cancer and underwent a mastectomy. Woodson also had a cancer scare and had to get additional testing.
For breast cancer, early intervention often leads to the best outcomes, lawmakers acknowledged.
“This is a bill that’s going to save lives and help to ensure cost is not a prohibition to accessing care,” said Democratic Rep. Anna Eskamani.
According to Senate staff analysis, 1 in 8 women will get diagnosed with breast cancer during her lifetime.
Lawmakers also pointed out men can get diagnosed with breast cancer too.
The state insurance program currently covers 100% of the costs for preventive mammograms, although the out-of-pocket fees, including copays, depend on the employee’s plan and provider for supplemental and diagnostic imaging that a person would need if the initial mammogram raises concerns.
The Senate staff analysis calculated the bill’s fiscal impact at $3.6 million annually.
“The bill’s prohibition on out-of-pocket costs for diagnostic and supplemental breast examinations has the potential to generate a higher insurance premium for the state group health plan,” the analysis found. “Historically, the state has covered premium inflation in the Program with General Revenue, rather than passing on premium increases to employees.”
The analysis also pointed out, “Early diagnosis increases the likelihood of successful treatment, which may result in savings for health insurers and HMOs.”
The Senate passed SB 158 with a 38-0 vote last month.
