HARRISBURG, PA — In a significant move towards promoting equitable healthcare access, Representative Curry (D-Delaware County) is working alongside Susan G. Komen® to eliminate financial barriers that hinder early detection of breast cancer in Pennsylvania.
In the Keystone State, over 12,830 individuals were diagnosed with breast cancer, and more than 1,870 succumbed to the disease in 2023 alone. High out-of-pocket costs associated with essential breast imaging procedures, which can range from hundreds to thousands of dollars, often force people to make the difficult choice between skipping these critical tests or making significant financial sacrifices.
“Nobody should have to forego a test that helps to rule out breast cancer or confirm the need for a biopsy because of the cost, yet thousands of people in Pennsylvania are doing it every year,” said Molly Guthrie, Vice President of Policy and Advocacy at Susan G. Komen. “This bill is a vital step towards equitable access to care, potentially saving lives by facilitating early detection and treatment.”
Introduced by Representative Curry, House Bill 1944 proposes to eliminate patient out-of-pocket costs for medically necessary diagnostic and supplemental breast imaging, including MRIs, ultrasounds, and diagnostic mammograms. While no-cost mammograms are currently available to women, when a mammogram reveals an abnormality, follow-up diagnostic and supplemental imaging is necessary to determine if a biopsy is needed. The high out-of-pocket costs for this crucial follow-up imaging deter many Pennsylvanians from pursuing it, often resulting in later-stage breast cancer diagnoses.
The proposed legislation aims to amend The Insurance Company Law of 1921, further providing for coverage for mammographic examinations and breast imaging. It was referred to the insurance committee on January 9, 2024.
An estimated 12% of individuals are called back for additional imaging after an abnormal screening mammogram and require diagnostic imaging. These costs create inequities in care and impose additional financial barriers on patients, especially those previously diagnosed with breast cancer or considered high-risk.
Despite advancements in breast cancer screening and diagnostics over the past 30 years, disparities persist across demographic groups. Black and Hispanic breast cancer patients tend to be diagnosed at a later stage, potentially due to delays in follow-up imaging after abnormal findings on an annual mammogram.
A Komen-commissioned study revealed out-of-pocket costs for patients ranging from $234 for a diagnostic mammogram to more than $1,000 for a breast MRI. Additionally, a recent study published in Radiology found that 1 in 5 patients would not go in for recommended follow-up imaging if they had to pay a deductible.
The proposed legislation underscores the urgent need to address the financial barriers that deter many Pennsylvanians from pursuing potentially life-saving diagnostic procedures. It emphasizes the importance of early detection in improving breast cancer survival rates and reducing health disparities among different demographic groups.
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