Wisconsin women with breast cancer urged support for a bill to cover additional screenings, saying while it might be too late for them, the change could save others’ lives.
SB 121, introduced by Senate Health Committee Chair Rachael Cabral-Guevara, would require health insurance policies to cover supplemental screenings for those at an increased risk of breast cancer, such as those with dense breast tissue, and those who have abnormal mammogram results.
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Under current law, health insurance policies must cover two mammograms to screen for breast cancer for women from ages 45 to 49 if certain requirements are met, and annual mammograms starting at 50 years old.
Cabral-Guevara during Wednesday’s hearing said mammograms don’t always show the full results for people with dense breasts, arguing the bill would close a critical loophole.
“Under no circumstances should cancer be allowed to spread undetected … after getting a screening such as a mammogram,” the Appleton Republican said.
About 40 percent of women have dense breast tissue, according to the CDC. A number of women with dense breast tissue shared stories about how they received normal mammogram results but were later diagnosed with cancer.
Neenah resident Gail Zeamer said she was diagnosed with breast cancer after an ultrasound exam of a swollen lymph node under her arm. She said her doctor found a nearly 4 centimeter tumor after she was initially told the lump was a cyst.
Zeamer said her doctor told her the tumor was difficult to see due to dense breast tissue.
“And basically, he told me finding your tumor was like finding a polar bear in a snowstorm,” she said.
Zeamer said she is now fighting stage four metastatic breast cancer.
“This bill unfortunately will not save my life, and I know that sitting here today. But I know it’s so important in saving the lives of thousands of women in Wisconsin who will be diagnosed after me,” she said.
Alliance of Health Insurers Executive Director R.J. Pirlot spoke against the measure, arguing at the hearing that additional screenings may not be necessary.
“Unfortunately, the legislation before you, though well intended, suggests that by simply having heterogeneous or extremely dense breast tissue, a woman should have supplemental breast screening or a diagnostic breast examination. We don’t believe the latest science supports this.”
Pirlot said AHI generally opposes the state dictating copay amounts or whether a copay is required.
Sen. Tim Carpenter said concerns over costs were also a factor before the state started requiring insurance policies to cover mammograms for women in certain age groups.
“Now what we’re doing is having to take a step further because we know more technology and more women finding out about dense breast tissue. My sister had it, and she had no idea,” the Milwaukee Dem said.
Carpenter during the hearing questioned, “how many people have to pass away in order for this to be covered?”
Cabral-Guevera also pushed back on the opposition, directing her remarks at Dr. Julie Mitchell, Anthem regional vice president & senior clinical officer, who spoke alongside Pirlot.
Cabral-Guevara said she’s not as confident in mammogram results as other types of screenings.
“We sit with our patients and we say, ‘Listen, we got your mammogram back here, it looks great. Now we’re 100 percent sure you don’t have cancer.’ Well, there are women here today, that that was wrong,” she said. “So is that malpractice? Is somebody, who’s held accountable for that?”
See the bill:
https://docs.legis.wisconsin.gov/2023/related/proposals/sb121
