Bipartisan bill would expand coverage for breast cancer screenings

Insurance providers would be required to provide supplemental breast cancer screenings, which are needed by roughly 40% of women in order to properly detect cancer, under a bipartisan bill being circulated in the state Legislature.

The measure expands on legislation signed into law in 2018 that requires medical facilities to give patients with dense breast tissue information about breast density, which can hide tumors on a mammogram.

An estimated 40% of women have dense breast tissue, which can require supplemental screenings such as ultrasounds or MRIs. Out-of-pocket costs for such screenings can be between $230 and $1,000, according to a memo prepared with the legislation.

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"Any cost barrier at this point could be the difference between a breast cancer that's detected early, when it's most treatable, and one that's already spread beyond the breast," Dawn Anderson, with the Wisconsin Breast Cancer Coalition, said at a press conference Tuesday.

"We have the technology to identify early tumors in women with dense breasts ... but that means nothing if those who need it cannot access it because of cost," Anderson added.

Currently in Wisconsin, health insurance policies must cover two breast exams for women between the ages of 45 and 49 if certain criteria are met. Annual mammograms must be provided to women 50 and older.

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Higher breast density is associated with a higher risk for breast cancer and can hide cancerous tumors in standard mammogram screenings, according to the Centers for Disease Control and Prevention.

Gail Zeamer was diagnosed with stage 3 breast cancer in 2016. Her tumor was not detected by previous mammograms and was only revealed after she had an ultrasound.

Zeamer worked with lawmakers to create the breast density law signed in 2018, but on Tuesday said more needs to be done to ensure all women have access to supplemental screenings when necessary.

"We need a cure for breast cancer, but in the meantime we need to find it early so that women have a better chance of treating the disease and of longtime survival," Zeamer said.

Sen. Rachael Cabral-Guevara, R-Appleton, who announced the bill alongside co-author and cancer survivor Rep. Nate Gustafson, R-Neenah, said the bill is similar to previous legislation that failed to reach Gov. Tony Evers' desk last session. Cabral-Guevara said the new bill eliminates the out-of-pocket cost for patients, rather than capping it, as the previous bill had proposed.

"It's time to remove the hurdles preventing so many women from getting the lifesaving cancer screenings they need," Cabral-Guevara said. "Early detection leads to better outcomes, and it reduces costs in the long run. This is an opportunity to deliver a big win for those who need it."

State Reps. Amy Binsfeld, R-Sheboygan, and Lee Snodgrass, D-Appleton, have also sponsored the bill.

Inside the battle over the upcoming 2-year Wisconsin budgetOver the next several months, the Republican-led Legislature and Democratic Gov. Tony Evers will battle their way through the the 2023-25 biennial budget process as the state has a projected surplus of more than $7 billion.