HARRISBURG — Separate bills that would eliminate out-of-pocket fees for certain genetic tests and additional breast cancer screenings were submitted to the Pennsylvania Senate Committee on Banking and Insurance this week and are pending a potential vote by the House of Commons. upper house of the General Assembly.
The House and Senate each have six sitting days remaining in the current session. If either or both bills are to pass, lawmakers must act quickly. If neither were approved and enacted, they would be expected to be reintroduced in 2023.
Senate Majority Leader Kim Ward, R-Westmoreland, sponsored Senate Bill 1330. It aims to prevent insurers from charging patients for the costs of genetic counseling and, if indicated after counseling, genetic testing for mutations in the BRCA 1 and BRCA 2 genes.
According to the Centers for Disease Control and Prevention, both genes can protect against certain cancers, however, mutations in either prevent them from working properly and increase the risk of developing breast, ovarian and cervical cancers. other cancers. Not everyone who inherits a mutation in either gene will develop cancer, the CDC says.
About 3% of breast cancers, or 7,500 women per year, and 10% of ovarian cancers, or about 2,000 women per year, develop from inherited mutations, according to the CDC.
Mutations significantly increase cancer risk for people with the mutations: up to 72% and 69%, respectively, for the two mutations for breast cancer; up to 44% and 17%, respectively, for ovarian cancer, according to the National Cancer Institute.
Men are also at risk. Citing Penn Medicine’s Basser Center for BRCA, a statement from Ward indicates that nearly 25% of men with BRCA mutations develop prostate cancer.
“Early detection saves lives,” Ward said in a joint bills statement. “As an individual who has benefited from genetic testing, I can say that this legislation will go a long way in helping individuals remain vigilant about regular testing or determining the best course of treatment.”
Senate Bill 1225 is sponsored by Sen. Bob Mensch, R-Berks. The bill asks health insurers to cover the costs of an additional annual breast screening for women at high risk of breast cancer during their lifetime. Insurers could not apply the cost to a deductible or coinsurance or charge a copayment, according to the bill.
MRI and ultrasound coverage under Bill 52 of 2020 would extend to women with a personal history of atypical breast histologies, a personal or family history of breast cancer, a genetic predisposition to breast cancer breast, previous therapeutic chest radiation therapy, extremely dense or heterogeneous breast tissue. on the breast composition categories of the Breast Imaging and Reporting Data System established by the American College of Radiology, the bill’s memo says.
Additional screening is needed, according to the joint statement, due to the failure of early detection by screening mammography in women with dense breasts and those at high risk for lifetime breast cancer.
“Research and experience tell us that the best way to stand a chance of beating this deadly disease is to know the risk factors and early detection. Both bills remove the barriers to early detection faced by thousands of Pennsylvanians, and the vote (from this week’s committee) signals another monumental step taken by this legislature to combat and eventually eliminate breast cancer,” Mensch said.
A study published by the Journal of the American Medical Association, a peer-reviewed medical journal, found that MRIs were significantly more effective at detecting breast cancer than 3D mammograms.
Another study, this one published in the Journal of the National Cancer Institute, found that the average cost of an MRI was $549 for women whose insurance had a high deductible. The study looked at insurance data between 2009 and 2017 and included more than 16,000 patients. It found that the rate of those with no disbursements fell from 43% in 2009 to 26% in 2017.
The Brem Foundation to End Breast Cancer in Maryland puts the average cost at $1,084, and there are numerous media accounts of women being charged much more.
Pat Halpin-Murphy, president and founder of the Pennsylvania Breast Cancer Coalition, greeted Ward and Mensch as well as Banking and Insurance Committee chairs Sen. John DiSanto, R-Dauphin, and Sen. Sharif Street, D-Philadelphia , for acting on the bill.
“When passed, this legislation will mark another major milestone in our joint efforts to ensure the possibility of early detection for every woman in Pennsylvania,” Halpin-Murphy said of the genetic testing bill before to pass the bill on free MRI and ultrasound. “There are high-risk women living with breast cancer right now in our state, and they don’t know it because they can’t afford the MRI that will find it. Senate Bill 1225 will change that. Cost shouldn’t be a barrier for a high-risk woman to get the life-saving breast MRI.
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