January 19, 2023

Breast cancer detection bill could eliminate co-pays, save lives

A bill to help breast cancer patients and, potentially, reduce mortality rates in New Mexico awaits a hearing in the current legislative session.

The bill, Breast Exam Health Coverage, or HB 27, would end cost-sharing costs for individuals who require additional breast imaging to detect breast cancer according to Rachel Birch, the director of State Policy and Advocacy for Susan G. Komen, a breast cancer research and advocacy organization.

Rep. Christine Chandler, D-Los Alamos, is sponsoring the bill. Chandler said by email that “early detection is key to treating breast cancer.”

“Unfortunately, right now patients who are at higher risk or need follow-up tests after an abnormal mammogram often face out-of-pocket costs that are extremely burdensome or prohibitive, even with commercial insurance. By eliminating those costs, we can make it easier for patients to detect breast cancer in its earliest stages, which means more New Mexicans will have access to lifesaving care,” Chandler said.

Birch said that the Affordable Care Act covers health preventive measures, such as an annual mammogram, but if a patient requires additional imaging, the cost can range from hundreds of dollars to over $1,000 in cost-sharing.

That is also true for patients who have private medical insurance, Birch said.

The problem is also an equity issue because breast cancer is often detected at later stages in women of color, Birch said. She said the cost sharing creates a barrier for individuals with a lower-income status. She said she has heard stories of women having to apply for a high interest payday loan to afford the copay necessary for an MRI imaging, which can be $1,000 or more.

For women who have breast cancer, particularly if they are in the later stages of breast cancer, the costs continue if they lose one or both breasts and need reconstruction surgery.

“Treatment options are better and the outcomes are better and costs much less not only for the patient, but for insurers, if the cancer is detected early. The only way to the best treatment is early diagnosis,” Birch said.

Birch said that Black women are on par with white women for breast cancer screening rates but die at 46 percent higher rate than their white counterparts from breast cancer. Birch said that a later-stage diagnosis is one of the factors for that higher mortality rate.

In studies conducted by Susan G. Komen, Indigenous women were found to be less likely to be diagnosed with early stage breast cancer that has not spread to the lymph nodes. Once cancer spreads beyond the breast, treatment becomes more costly and treatment options are more limited, Birch said.

Breast cancer is also the most common cancer diagnosis for Latina women and the leading cause of death for Latina women.

Birch said nine other states have already passed similar legislation over the last three to four years.

Susan G. Komen estimates that in 2022, an estimated 1,700 breast cancers were detected in individuals in New Mexico and an estimated 290 died from the disease.

“This legislation will be a huge win for New Mexico women to ensure diagnosis and cancer treatment at earlier stages,” Birch said.