Like many women, Pennsylvania Senate President Pro Tempore Kim Ward delayed getting her annual mammogram in 2020 because of the COVID-19 pandemic.
And when she did that November, her doctor told her she had Stage 1 breast cancer.
“I kept thinking, jeez, if I had my mammogram on time, would they have seen it because they did not offer me an ultrasound or an MRI even though I had fibrous breast tissue? Or if I just waited until it was due again, it would probably have been Stage 2,” said Ward (R-Westmoreland).
“As it is now, many women have to pay a co-pay for an MRI or ultrasound, depending on their insurance,” she explained, noting that could cost $600 to $1,000. In talking to women, some told her they even have to pay out of pocket. And that cost can be huge if they need to pay their rent or feed their family, she said.
Ward decided to do something about it. Senate Bill 8, which passed the Senate last year and again this year, would require insurers to cover 3D mammograms, ultrasound, and MRI testing.
“One lady said, ‘I cried that day it passed because my mother had breast cancer twice. They didn’t test her for it, and they would not pay for her to have an MRI.’”
“These are the people we’re trying to ensure get the care they need,” said Ward.
SB8 is the first-of-its-kind in the nation comprehensive breast cancer screening and testing bill that eliminates all costs associated with genetic testing and counseling. It also covers breast MRIs and ultrasounds for Pennsylvanians with high-risk conditions like dense breast tissue, a personal history of breast cancer, a family history, a genetic predisposition, or prior radiation therapy.
While undergoing treatment, Ward also learned she had the BRCA gene, meaning she was among those with an 80 percent risk of developing breast cancer. But she had to pay for that test out-of-pocket because her insurance would not cover it since her mother and sister had not had breast cancer, although her grandmother and great-aunts did.
“I had the lumpectomy,” she said. “I started chemotherapy. About my third chemo treatment, my oncologist said, ‘I’m going to order you that (genetic test). And then they wouldn’t pay for it. And I said, ‘Well, I’m going to pay for it.’”
When it came back positive, she had mastectomies because, with the BRCA gene, that is the only way to be sure the cancer would not reoccur.
“It’s truly preventive,” she said about the test. Her sons and grandchildren can be tested to be sure they don’t have the gene, which can lead to an increased risk of prostate cancer. It also increases the risk of ovarian cancer.
If SB8 is passed by the House and signed into law by Gov. Josh Shapiro, Pennsylvania will become the first state to require coverage for 3D mammograms at no cost to the patient. SB8 is expected to be acted on in the House on Wednesday after being unanimously passed by the House insurance committee Monday. It would include requirements that insurers pay for the testing when prescribed.
SB8 is also the first bill of its kind to require coverage of genetic testing and counseling and breast MRI and ultrasound at no cost to women at high risk.
Ward is working with House Speaker Joanna McClinton (D-Philadelphia/Delaware) toward advancing the bill. If it becomes law, it will help 14,000 Pennsylvania women who get breast cancer each year.
“Breast cancer is a terrible disease,” said McClinton. “The statistics are sobering with roughly 264,000 cases of breast cancer diagnosed in women and 2,400 cases in men. For Black women, the statistics are even more alarming, as it is the number one cause of cancer death for Black women at an alarming rate of 31 percent.
“Still there is reason for hope. Due to advances in research and science, testing and genetic counseling is now available to anyone with a family history of cancer. This will help in the fight to early cancer diagnosis. That said, no one should have to forgo a lifesaving important screening because they cannot afford a co-pay, deductible, or co-insurance payment. I applaud my Senate colleagues and Senate Pro Tempore Ward, herself a survivor, for introducing this legislation and I am pleased to prioritize this bill’s movement in the House,” said McClinton.
DVJournal asked Ward if she is getting pushback from health insurers.
“Maybe a little at first,” she said. “They weren’t all the way thrilled, but they’re okay now. They’re working with us.
“This is not a red or blue issue. It is a pink issue, and we need to encourage other states to follow and ensure that women are getting regular breast examinations as ‘early detection saves lives,’” said Ward.
State Sen. Tracy Pennycuick (R-Bucks/Montgomery) said, “The overwhelming support this first-in-the-nation legislation is receiving, and its swift, unanimous passage shows just how important and prevalent these issues are in Pennsylvania. There isn’t a person in our commonwealth who hasn’t been touched by breast cancer, and, like so many others, my family knows the devastating toll this disease can have. Thank you to the House insurance committee chairman and members for their quick consideration and passage of Senate Bill 8.”
“I think that all of the proposed measures will increase access to valuable tools to preserve women’s health,” said Dr. Robert Michaelson, a retired gynecologist in Montgomery County.
Ward said she is well now and cancer free since her cancer had not spread to her lymph nodes.
“Thank God it was not in my nodes,” Ward said. But the oncologist said it was on the way to spreading, she added. If she had been tested for the BRCA gene, she would have had the mastectomies, not undergone a lumpectomy first.