Pappas-Backed Law Expanding Critical Medical Coverage for Breast Cancer Patients Soon in Effect

SPRINGFIELD, Ill. – A new law backed by state Rep. Diane Pappas, D-Itasca, requiring insurance companies to cover lifesaving breast cancer screenings will go into effect Jan. 1.

“Diagnostic mammograms are a critical tool doctors use to detect breast cancer early and save countless lives each year. For the wellbeing of women everywhere, all health care plans should cover this procedure,” Pappas said. “When diagnostic mammograms aren’t covered, they often pose a significant financial burden for the patient, who has to weigh the cost of the procedure against the risk of breast cancer. No one should ever have to make a decision like that.”

Pappas helped pass Senate Bill 162, which expands coverage for mammograms. Beginning next month, insurance companies will be required to cover diagnostic mammograms, which are typically done to follow up and collect more information after a preventative screening indicated signs of breast cancer. Currently, regularly-scheduled preventative mammograms must be covered, but physician-requested diagnostic mammograms are not, and patients are forced to share the cost of the procedure.

In 2016, the CDC reported 17.3 million mammograms. In about 12% of cases, women were called back for another, more thorough diagnostic mammogram—which is currently not covered by many health insurance providers. Estimates indicate that doctors regularly requesting a second mammogram has lowered cancer mortality by about 40%.

“I’m fighting to build a stronger Illinois with more affordable health care for everyone. Making sure people can pay for their health care is never more important than it is in the case of diagnostic mammograms,” Pappas said. “Starting this January, insurance companies won’t be allowed to put profits above patients when it comes to this procedure.”