Find It Early Act Would Ensure Payment for Breast Screening Exams

Legislation called the Find It Early Act was introduced into the U.S. House of Representatives on December 13 that would boost early detection of breast cancer by requiring health insurance payment for screening and diagnostic breast imaging exams, including screening and diagnostic mammography, breast MRI, and ultrasound.

The Find It Early Act is being sponsored by Rep. Rosa DeLauro (D-CT) and Rep. Brian Fitzpatrick (R-PA). Both DeLauro and Fitzpatrick also worked together on the Breast Density and Mammography Reporting Act of 2019, which requires the U.S. Food and Drug Administration (FDA) to issue a federal standard requiring breast density status to be included in all mammography reports.

Accompanying DeLauro and Fitzpatrick at a December 13 press briefing in Washington, DC, announcing the legislation was television journalist Katie Couric, who was diagnosed with breast cancer two months ago and has received treatment. Also in attendance were other stakeholders in the women’s health community, including breast density advocate JoAnn Pushkin, executive director of DenseBreast-info.org.

Clinical guidelines recommend that breast screening begin at age 40 (although some more conservative guidelines recommend starting at 50). At either age, this creates a gap between when women are advised to get screening and when Medicare begins paying for it. Women therefore either have to have private insurance or must pay for screening out of their own pockets.

This can impede the early detection of breast cancer, DeLauro noted. When detected early, breast cancer can have a five-year survival rate of 99%, but when detected at a late stage and after it has metastasized to other parts of the body, five-year survival is under 30%.

The situation is particularly worrisome for women with dense breast tissue, as cancer can be difficult to detect in dense tissue with conventional x-ray-based mammography. Pushkin told of her own story, in which her breast cancer was missed for five straight years – even though she received a screening mammogram every year. She only found the cancer after performing a breast self-exam; it was confirmed with ultrasound.

Couric noted that the challenge of early detection is often intertwined with the problem of breast density – but even when women are aware of their density status, economics can present another hurdle to getting the care they need.

“And when patients are properly informed, they often forgo additional testing like breast ultrasounds or MRIs because they can’t afford it, or their insurance doesn’t cover it,” Couric said during the press briefing. “The Find It Early Act will help level the playing field for women who need and deserve to have thorough breast cancer screening.”

Pushkin noted that DenseBreast-info is frequently contacted by women expressing frustration with having to navigate a byzantine process to get insurance companies to pay for their screening exams. The act will also bar insurance companies from requiring women to contribute co-pays for their exams.

“The Find It Early Act will help ensure that when a woman is told she needs more screening, she will not have to struggle to pay for additional imaging, or choose between household bills and a recommended test, or skip an MRI because the cost has strained the family budget,” Pushkin said.