Cabral-Guevara/Gustafson bill provides critical access to supplemental or diagnostic imaging
[Madison, Wis.] – Today, the Senate Committee on Health held a public hearing on Senate Bill 121. The bipartisan bill – which is co-sponsored by over one-third of the Legislature – increases access to life-saving breast imaging by eliminating patient cost-sharing for those with dense breasts and those at increased risk of breast cancer.
Those who testified in support of the bill today include brave breast cancer fighters, advocates, and leading health organizations, including the American Cancer Society Cancer Action Network, Susan G. Komen, the Wisconsin Breast Cancer Coalition, the Medical College of Wisconsin, the Wisconsin Radiological Society, and the Wisconsin Nurses Association.
Gail Zeamer, a health advocate and breast cancer fighter, spoke to the need for SB 121: “Patients like me need more when it comes to screening for cancer. Right now, patients are forced to make a decision about getting the needed screening and paying out-of-pocket or foregoing the screening and taking a chance with potentially life-changing, later stage diagnoses.”
The bill, authored by Sen. Rachael Cabral-Guevara (R-Appleton) and Rep. Nate Gustafson (R-Neenah), builds on the notification required in 2017 Act 201 that all facilities that perform mammograms must provide notice to patients with dense breast tissue. SB 121 requires health insurance policies to include coverage with no patient cost-sharing for supplemental or diagnostic breast examinations for those at increased risk for breast cancer according to guidelines established by the National Comprehensive Cancer Network and those with dense breasts as defined by the American College of Radiology’s Breast Imaging-Reporting and Data System (BI-RADS).
Under current state law, health insurers are required to provide one annual mammogram to women over 50, and two to women aged 45-49 who meet certain criteria, at no out-of-pocket cost to the patient. However, for the 40% of women with dense breast tissue, where a mammogram alone may not be enough, the average out-of-pocket costs for diagnostic or supplemental breast screenings can range from $234 to over $1,000 dollars, according to Susan G. Komen, the world’s leading breast cancer organization.
“In Wisconsin, 5,460 women will be diagnosed with breast cancer in 2023 and 720 will die from the disease. Despite the fact that breast cancer death rates have been declining for several decades, not all people have benefited equally from the advances in prevention, early detection, and treatment that have helped achieve these lower rates,” said Sara Sahli, Wisconsin government relations director for the American Cancer Society Cancer Action Network – Wisconsin.
SB 121 ensures that men and women, regardless of socio-economic background, not only receive the information necessary for them to advocate for their own health, but also access to life-saving breast imaging.
“This legislation will help to eliminate the barriers to accessing supplemental breast imaging for individuals at a higher risk of breast cancer, making an immediate impact for the people of Wisconsin,” said Dana Carter, Regional Manager of State Policy & Advocacy at Susan G. Komen.
“When a woman gets that notification letter about her density after a mammogram, and has a discussion about it with her doctor, she has a decision to make. Any cost barrier at this point could be the difference between a breast cancer that is detected early, when it’s most treatable, and one that has already spread beyond the breast, when it becomes life threatening,” said Dawn Anderson of The Wisconsin Breast Cancer Coalition, Wisconsin’s foremost breast cancer advocacy organization.
Those interested in advocating for Senate Bill 121 are encouraged to visit EarlyDetectionWI.com to learn more and become involved.