New bill literally a lifesaver Breast cancer screeningsto be fully covered in Mass.

BOSTON — A ceremonial signing of a breast cancer screening bill on Monday by Gov. Maura Healey gave supporters an opportunity to gather and celebrate their work: ensuring that all breast cancer screenings are covered by health insurance.

"This bill will save lives," Healey said of the legislation that was sent to her desk by state legislators last week. "This is an issue that touches every family in the commonwealth."

The bill will ensure that all screenings are covered by health insurance for MassHealth (Medicaid) patients, government employees and those covered by private, commercial insurance.

"This advances awareness, research and improves policies around women's health," Healey said.

The new law requires all insurance plans covering screening mammograms to also cover diagnostic examinations for breast cancer, including digital breast tomosynthesis, breast MRI and breast ultrasound, without increasing patient cost-sharing.

The provisions will ensure that screenings beyond the initial recommended yearly mammograms for women are covered by insurance. In the past, only the initial screening was covered; additional diagnostic tools were not and could cost hundreds and even thousands of dollars out of pocket, depending on the tool used.

While most screenings are routine, 10% to 12% need follow-up diagnostics, said Dr. Ben Ebert, president of Dana-Farber Cancer Institute.

"This bill will make sure that those screenings are covered by insurance and that there is no barrier to continued screenings when needed," Ebert said.

The measure extends insurance coverage to more sophisticated diagnostic mammography tools, specifically those designed to screen women with dense breast tissue for cancers. It will go into effect at the start of the new year.

"The Affordable Care Act guaranteed that initial screenings were covered by insurance, but if there was a problem, an anomaly, these were not covered," said Dr. Craig Bunnell, chief medical officer at Dana-Farber and a breast oncologist.

The costs could be prohibitive, leading to delayed treatment for many women who could not afford the out-of-pocket costs for further diagnostic work.

"A later diagnosis could mean a cancer has reached Stage 3 or Stage 4, needing more aggressive treatment," Bunnell said. Later treatments could also be less effective and offer less of a possibility of a cure. They are also traditionally more toxic and more costly, he said.

Healey noted that early detection can save lives, and the legislation she signed eliminates barriers to early detection.

The American Cancer Society estimates that there will be 7,150 new cases of female breast cancer in Massachusetts in 2024 and 730 deaths. According to the Susan G. Komen breast cancer organization, there was a 44% reduction in the breast cancer death rate in the United States between 1989 and 2022 due to improvements in early detection and treatment.

While breast cancers are more prevalent in women 50 and older, there has been a 2% yearly increase over the last five years in cancers diagnosed in younger women, according to the Breast Cancer Research Foundation.

The trend is concerning as women under 40 are nearly 40% more likely to die from their breast cancer than women over 40, according to the foundation.

Currently, breast cancer is the leading cause of cancer death in women 20 to 49 in the United States.

According to the Massachusetts Breast Cancer Coalition, the incidence of female breast cancer in Massachusetts was higher than the national average: 140.3 cases per 100,000 women in 2021, compared to the national average of 134 per 100,000.

One in eight women in Massachusetts will get a breast cancer diagnosis at some point in their lifetime, and 71% of those who do have what is called dense breast tissue, which is more challenging to screen.

While roughly the same number of Black and white women are diagnosed with the disease, the death rate is 40% higher for women of color, according to Ebert.