Fitzpatrick, Cole bill removes cost barrier to breast cancer diagnostic testing

More women would be encouraged to seek early treatment for breast cancer under new bipartisan legislation introduced by U.S. Reps. Brian Fitzpatrick (R-PA) and Tom Cole (R-OK) that would make diagnostic testing more affordable.

Current law requires insurance companies to cover breast cancer screenings but not diagnostic tests such as an MRI or ultrasound that help determine whether cancer is present, Rep. Fitzpatrick’s office explained. That disparity in coverage results in additional copays and out-of-pocket expenses for patients.

“Key in the fight against breast cancer is timely diagnostic testing, which greatly increases a patient’s chance of beating this devastating disease,” Rep. Fitzpatrick said. “I am proud to join my bipartisan colleagues in introducing this legislation so that we can eliminate undue financial obstacles associated with diagnostic exams and increase access to the medical care that patients need.”

The lawmakers introduced the Access to Breast Cancer Diagnostics Act of 2021, H.R. 5769, on Oct. 28 with bill sponsor U.S. Rep. Debbie Dingell (D-MI) to require insurance companies to cover breast cancer diagnostic testing the same way screenings are covered.

“Women should not have to worry about the out-of-pocket costs of breast cancer diagnostic testing or delay a breast cancer diagnosis,” Rep. Cole said. “Indeed, early detection and diagnosis of breast cancer is critical to survival.”

According to the text of the bill, the legislation would amend the Public Health Service Act to prohibit group health plans and health insurance issuers offering group or individual health insurance coverage from imposing cost-sharing requirements or treatment limitations with respect to diagnostic examinations for breast cancer that are less favorable than screening examinations.

Rep. Dingell noted that one in eight women will develop breast cancer in her lifetime and that the bipartisan legislation would improve access to early treatment and care.

The bill is under consideration in the U.S. House Energy and Commerce Committee.