Susan G. Komen®, the world’s leading breast cancer organization, is committed to making health care more affordable and accessible to all, by passing state and federal legislation in 2024 to remove barriers that prevent people from receiving the timely and high-quality breast care they need.
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Breast Cancer outcomes are still influenced by a person’s race, income and where they live, but they should not be. Black women are 40% more likely to die from breast cancer than white women – due to delays in care or genetic factors that make them more likely to have an aggressive and deadly type of breast cancer. Public policies that remove obstacles, such as the cost of care and when and where care is available, would make an immediate difference in mortality rates. In fact, about one-third of breast cancer deaths could be prevented if everyone received the high-quality care that exists today.
“The only way to achieve true health equity is to ensure people in all 50 states, U.S. districts, islands, territories and tribal organizations have the same ability to seek and receive care, and unfortunately that’s not the case,” said Molly Guthrie, Vice President of Policy and Advocacy at Susan G. Komen. “While our collective work has improved breast cancer outcomes, decreased mortality from the disease and paved the way for improved, affordable care, our mission is far from complete. We are still in need of critical changes to state and federal laws, essential for implementing long-term and lasting improvements that save lives.”
Fortunately, legislation has already been introduced or will be introduced this year that removes barriers to care and gets us closer to achieving health equity. Susan G. Komen’s Center for Public Policy is committed to working alongside policymakers from both parties in states and in Washington, DC to enact new policies that make breast imaging and follow-up testing more available and affordable, make needed benefits and treatment available to people with advanced breast cancer and help us detect genetic risk factors earlier, when actions can be taken to hopefully save lives.
Breast imaging, the most effective tool at detecting breast cancers, is available to most people yet is not accessible to all. At the federal level, the SCREENS For Cancer Act would support state and local programs that provide no-cost breast and cervical examinations for people who are uninsured or underinsured through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Since the program’s inception in 1991, the NBCCEDP has served more than 6.1 million people, detecting nearly 77,000 invasive breast cancers. The legislation is needed to expand access in under-resourced communities, where access to screening and diagnosis remains a key barrier.
Diagnostic and supplemental breast imaging, a critical step when a screening mammogram detects an abnormality or for those considered to be at high-risk for breast cancer, is often inaccessible or unaffordable. These tests can range from hundreds-to-thousands of dollars, out of pocket, and people often forgo them due to cost. States and the federal government must pass legislation to eliminate out-of-pocket costs for everyone.
Already in the 2024 legislative session, 11 states are considering legislation to eliminate the patient cost of this needed imaging, and more states are expected to introduce bills in the coming weeks. Twenty states have already enacted legislation. Federal action must also be taken, and the Access to Breast Cancer Diagnosis Act is pending and supported by lawmakers in both parties in the U.S. House and Senate.
Metastatic breast cancer (MBC) affects more than 168,000 women and men in the U.S. As MBC cannot be cured, treatment focuses on extending life and maintaining quality of life, but the average life span is 3 years after diagnosis. Under current law, MBC patients are subject to a 5-month waiting period for Social Security Disability Insurance and a staggering 24-month waiting period for Medicare benefits. Patients cannot afford to wait and many die before they receive any federal help.
The Metastatic Breast Cancer Access to Care Act, backed with bipartisan support, is the only way to make benefits available right away to people living with MBC. At the state level, the Center for Public Policy is also leading legislation that would prohibit those living with advanced disease from being subjected to step therapy protocols, Step therapy, also referred to as “fail first,” requires a patient to first try a health plan preferred drug, have that drug fail them – meaning the treatment didn’t work for the patient – before they can use the treatment their provider prescribed.
While breast cancer cannot be prevented, identifying and mitigating genetic risk, which accounts for 5-10% of cases, can save lives. Unfortunately, the testing needed to learn one’s genetic predisposition to breast cancer is expensive and not attainable by all. The Reducing Hereditary Cancer Act would require Medicare to cover testing for some individuals with a known hereditary cancer mutation and those with a personal or family history due to genetics. For those with an inherited gene mutation, Medicare would also cover follow-up testing and imaging and risk-reducing surgeries.
The Center for Public Policy has worked with legislative champions in Illinois and Oklahoma to introduce bills that would eliminate financial barriers to clinically appropriate genetic testing and recommended screenings based on the results of that testing for state-regulated insurance plans (e.g. private group, state employees).
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“Komen is approaching breast cancer comprehensively through diverse public policy initiatives, aiming to minimize the number of breast cancer deaths,” Guthrie added. “We cannot accept a reality where only some people can get the health care and help, they need. Our goal is to ensure everyone has access to what they need, when they need it, so that all can benefit.”
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