Measure to cut patient costs for breast cancer testing advances out of Pa. Senate

Mar. 10—HARRISBURG — The Pennsylvania Senate moved this week to unanimously advance a bill to the state House that would eliminate co-payments, deductibles and co-insurance for certain genetic testing and supplemental breast cancer screenings.

Senate Bill 8 proposes to amend state law to restrict insurers from charging patients for any costs related to genetic counseling and, if indicated after counseling, genetic testing for BRCA 1 and BRCA 2 gene mutations.

It also calls for health insurers to cover costs of an annual supplemental breast screening for women with a high lifetime risk of breast cancer.

MRI and ultrasound coverage under the existing Act 52 of 2020 would extend to women with a personal history of atypical breast histologies, personal or family history of breast cancer, genetic predisposition for breast cancer, prior therapeutic thoracic radiation therapy, extremely dense or heterogeneously dense breast tissue.

A study published by the Journal of the American Medical Association, a peer-reviewed medical journal, found that MRIs were substantially more effective in detecting breast cancer than 3D mammograms.

The bill advanced to the House where it was assigned for consideration by the Insurance Committee. It's a reintroduction that combined two bills that also moved out of the Senate last fall but not long before the prior legislative session ended.

Senate President Pro Tempore Kim Ward, R-Westmoreland, a breast cancer survivor, is the prime sponsor along with Sen. Devlin Robinson, R-Allegheny, and Sen. Tracy Pennycuick, R-Berks/Montgomery.

"I know first-hand the importance of genetic testing and supplemental screenings. In fact, had more testing and screening options been covered by insurance when I was diagnosed, my breast cancer may have been caught sooner or I may have considered a different treatment option," Ward said.

According to the Centers for Disease Control and Prevention, BRCA 1 and BRCA 2 can protect against certain cancers, however, mutations of either cause them to work improperly and raise the risk of developing breast, ovarian and other cancers. Not everyone who inherits a mutation of either gene will develop cancer, the CDC states.

The mutations greatly enhance the cancer risk, including for prostate cancer among men, for those with the mutations: up to 72% and 69%, respectively, for the two mutations when it comes to breast cancer; up to 44% and 17%, respectively, for ovarian cancer, per the National Cancer Institute.

"(The) Senate vote is a huge, huge victory. Screenings like breast MRI are proven to be twice as effective than even 3D mammograms in women at high risk. Senate Bill 8 allows those women to receive the best screenings and testing available at no cost," said Pat Halpin-Murphy, president of the PA Breast Cancer Coalition. "We know Senate Bill 8 will save lives. Thank you, Senators Ward, Robinson and Pennycuick for introducing this urgently needed legislation and to all our senators for recognizing its impact. Now, on to the House of Representatives! Take action. Find it early. Save lives."