Portantino/Garcia Bill to Expand and Enhance Health Care Coverage for Necessary Breast Cancer Screening Sent to Governor

Wednesday, August 31 2022

For Immediate Release: August 31, 2022

Contact: Lerna Shirinian, (818) 409-0400

 

Portantino/Garcia Bill to Expand and Enhance Health Care Coverage for Necessary Breast Cancer Screening Sent to Governor

Sacramento, CA – Senate Bill, 974 authored by Senator Anthony J. Portantino (D – Burbank) addresses a significant flaw in women’s healthcare insurance coverage.  The bill fixes a delay and absence of live-saving early detection diagnosis by expanding health care coverage for diagnostic breast imaging following an abnormal mammography.  SB 974 has passed both houses of the Legislature and is on the Governor’s desk for signature.

“SB 974 recognizes the importance of follow up  diagnostic testing for breast cancer screenings,” stated Senator Portantino. “Health insurance only covers the initial mammogram and does not extend to these crucial follow-up diagnostics, which may save lives and significantly impact health outcomes for women.  I am thankful to Gayaneh Pezeshkian Avanes for suggesting this bill idea.  Her activism will help thousands of women.”

Breast cancer is the second leading cause of death among women of all races. Early detecting can reduce the risk of dying from the disease by 25-30%.  Health insurance coverage extends to mammography screening, which detects 80-90% of breast cancers in women who have not yet manifested physical symptoms. Women who receive abnormal results on a breast cancer screening can be instructed to undergo follow-up testing to ensure that the abnormality is not cancerous, and they are often required to pay out-of-pocket for follow-up testing.  This can cause thousands of dollars and cause many women to delay or avoid these appointments and thus delay treatment that can save their life.

"I am very grateful to Senator Portantino’s leadership and commitment to this important proposal and thank him for including me in the process,” stated Gayaneh Pezeshkian Avanes.  “SB 974 is the kind of forward-thinking legislation Californians need to save lives with early breast cancer detection that helps not only the women affected, but family and friends who surround them.  If this bill becomes law, women can make an appointment without worrying about how to pay for diagnostic imaging or avoid experiencing long waiting times. I am hopeful Governor Newsom will sign SB 974."

SB 974 would require that a health insurance policy, which is issued, amended, or renewed on or after January 1, 2023, to provide coverage for a medically necessary diagnostic breast imaging, including diagnostic breast imaging following an abnormal mammography result. Diagnostic breast imaging includes breast magnetic resonance imaging and breast ultrasound.

“I recently treated a patient, who, following her annual mammogram, was told she should have MRI for increased breast cancer risk due to family history.  After the MRI, she received a $800 bill since insurance did not cover this expense.  That patient later confided in me that she would not have done the MRI due to cost if she had known it would not be covered.  Thankfully, the results were negative but what if they had been positive?” said Dr. Laura Sirott, an OB/GYN and the Immediate Past Chair of the American College of OB/GYN’s District IX.  “Cost should not be a primary factor when it comes to making critical health care decisions.  SB 974 addresses this problem head on and makes it possible for patients to get diagnostic breast imaging following an abnormal mammography without having to pay out of pocket.”

"As a co-author of this bill, I am very excited that it passed the Legislature and is now awaiting signature from the Governor.  I applaud Mr. Portantino’s leadership.  I know firsthand the difficulty women must go through to get the necessary imaging tests approved because regular mammograms don’t work for me because of dense breast tissue.  Every year, I have to fight with my provider to approve the test that could save my life or I need to pay out of pocket to get follow up imaging, even after the regular mammogram fails," said Assemblymember Cristina Garcia (D-Bell Gardens).  "I can’t help but worry about the countless women, especially low income women of color, that cannot afford any out of pocket expenses for diagnostic testing and are not able to get the appropriate test to detect breast cancer in its early stages.  Removing barriers and giving California women the coverage for breast cancer imaging that they deserve will saves lives and create a more equitable health care system for our most vulnerable women."

 

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