Please ensure Javascript is enabled for purposes of website accessibility Bill requiring insurance coverage of breast cancer diagnostic imaging sent to governor’s desk

Bill requiring insurance coverage of breast cancer diagnostic imaging sent to governor’s desk

HARRISBURG, Nov. 21 – State Rep. Gina H. Curry, D-Delaware, celebrated the passage of legislation that will require insurance policies to cover all medically necessary diagnostic breast exams, a move that will significantly lower patient costs.

Senate Bill 88, which was introduced in the Senate in June and Wednesday passed the House by a vote of 196-7, mirrors Curry’s legislation, H.B. 433, which passed the House and was sent to the Senate in May.

The new legislation amends the Insurance Company Law of 1921 to require all insurance plans operating in Pennsylvania to cover all diagnostic breast exams, including diagnostic mammograms, ultrasounds and MRIs, after a standard screening mammogram shows an abnormality.

Many people have access to free annual breast cancer screening mammograms through their health insurance. When an abnormality is found on a screening mammogram, many patients are sent for more advanced imaging, including ultrasounds and breast MRIs. Under current law, these more advanced tests often require the patient to cover a portion of the cost out of pocket because their insurance policies don’t cover the total cost. 

“Facing the possibility of breast cancer after an abnormal mammogram is already emotionally stressful,” Curry said. “Adding financial burden leads to overwhelming consequences. Some individuals can’t readily shoulder the costs of added tests and either delay them until they can or forego them completely. We shouldn’t be asking people to delay the start of potentially life-saving treatments because the cost of a final diagnosis is too high.”

A 2019 study completed by the Susan G. Komen Foundation found that out-of-pocket costs for follow-up tests can range from $234 to $1,100. For some, these costs are prohibitive and lead to delays in diagnosis and treatment.

“I’m proud to see this bill on its way to the governor’s desk,” Curry said. “I’ve dedicated significant time and effort to making this legislation possible and easing the burden on people confronting a breast cancer diagnosis. This will allow more patients to focus on healing rather than the financial strain of essential diagnostic tests.”