New law means no co-pays for advanced breast cancer diagnostic tests in Minnesota
MINNETONKA, Minn. — Soon, Minnesotans who need breast cancer diagnostic testing beyond a mammogram won't pay out-of-pocket for that care.
Starting at age 40, mammograms for women at high risk for breast cancer are covered under the Affordable Care Act. And at age 50, patients can get the preventative check every two years. But additional tests can mean big bills.
But a new state law eliminates cost sharing for the advanced screenings, like a MRI or ultrasound, when a physician determines the tests are necessary. And they can be cost prohibitive for patients: A study commissioned by the Susan G. Komen Foundation found patients can pay more than $1,000 for a breast MRI even with insurance.
The change to cover more tests, which passed as part of a larger health budget bill in the state legislature this spring, takes effect Jan. 1.
The issue is personal for Rep. Patty Acomb, DFL - Minnetonka, a breast cancer survivor who needed the additional testing herself and was surprised her insurance plan didn't cover all the cost. Lucky for her, she could afford it, she said. But she knows that isn't true for everyone.
"This bill is really designed to remove those barriers because we know good outcomes come from early diagnosis and we want all patients to have that same opportunity for good outcomes that I received," she explained.
On Tuesday during a roundtable with U.S. Rep. Dean Phillips of Minnesota's Third Congressional District, Angela Nelson, manager of Jane Brattain Breast Center, said many women who visit their clinics say they can't afford the big bills for the diagnostic testing.
She urged Phillips to get Congress to pass legislation requiring that insurance cover it with no added expense to patients nationwide.
"I can't tell you how many women I've talked to in my years of being with breast center who have said I cannot afford to have these diagnostic services," she said. "It's heartbreaking."
A mammogram might not be enough to detect cancer for everyone, Dr. David Aamodt, director of breast imaging at Allina Health Cancer Institute, told WCCO earlier this year — especially for the 40% of patients with dense breast tissue. That can make the mammograms harder to read, obstructing potential abnormalities that might raise red flags.
"Breast density adds an extra layer, which impedes the x-rays from going through the breast tissue and finding an area we're concerned about," he said. "For a lot of women, a mammogram will be sufficient. But for some women we've seen that adding an extra screening modality like MRI or ultrasound can really increase the number of cancers we find and find them at a much earlier stage, which will lead to much better treatment outcomes."
