Utah bill to expand breast cancer coverage put on hold

SALT LAKE CITY — A bill that would have eliminated cost-sharing from follow-up breast cancer examinations is now on hold.

Initial mammography screenings are fully covered by insurance companies due to federal guidelines. This Utah bill, HB314, would expand that coverage to include follow-up breast cancer exams like MRI and ultrasound screenings.

The bill had its initial hearing in the Utah House Business, Labor, and Commerce Committee meeting earlier this week, where several advocates explained the benefits of the bill, while committee members raised questions about financial impacts.

How the bill could save lives

“We’re trying to make sure that patients can see out the whole screening evaluation process without delay, without financial challenges, before they’ve even started treatment,” explained Conor Sweeney, an advocate with the Susan G. Komen Foundation.

Studies by the American Cancer Association and Susan G. Komen Foundation find that removing financial barriers for additional necessary breast cancer screenings could improve early detection.

“To reduce the burden of breast cancer on individuals, families, communities, and the greater healthcare system, my organization advocates for policies to promote early detection,” Sweeney said. “This bill is one of those policies.”

The five-year survival rate for early stage breast cancer is around 99%. However, when allowed to metastasize, the survival rate drops to around 31%.

Advocates for the bill argue that early detection ultimately saves lives and reduces the cost of future breast cancer treatments if not caught at an early stage.

“[Estimates show] that removing out-of-pocket cost-sharing will save nearly $12,000 dollars of lifetime cancer treatment costs per diagnosed patient,” Sweeney said. “Leading to upwards of $2.2 billion in savings in total lifetime cancer treatment costs nationwide.”

Missing fiscal and economic impacts

Committee members had many questions about the noted fiscal impact statements and how it may negatively affect small businesses.

“I don’t think the fiscal note is reflecting what it’s supposed to reflect,” said Rep. James Dunnigan, R-Salt Lake. “[It] doesn’t even talk about the cost of the private sector, we’re just talking about the public sector. Because the private sector, particularly small business, is going to be impacted by this.”

The current fiscal note does not include all potential costs to PHP, higher education, and all public employees.

Because of the lack of data, committee members asked to place the bill on hold until accurate impacts can be calculated.

Even with a correct fiscal statement, some committee members questioned the efficiency of this bill.

“If three out of four people are already getting it, and they’re already paying for it and they’re figuring it out, in order for us to get the one out of four, we have to pay four times. Because we not only have to pay for the one who’s not getting it, we also have to pick up the tab for the three who are getting it,” said Rep. Norman Thurston, R-Utah. “So it costs us four times as much, which is why that piece of data is so important that we don’t have.”

Rep. Thurston also expressed his concern for potential negative impacts on small businesses.

“Whenever we start loading [mandated coverage] up… it makes the cost of coverage higher and it’s more likely that small businesses are just going to walk away,” Thurston said.

He continued, “We need to be more logical and effective about how we’re going to use any public money so that we are getting the maximum amount of coverage and service for the limited dollars that we have.”

Committee members voted to place the bill on hold.

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