Legislation introduced in the U.S. Senate would eliminate out-of-pocket costs for diagnostic mammograms. Advocates say it could save lives. GPB’s Ellen Eldridge reports.

Woman holds pink ribbon to her chest

The Access to Breast Cancer Diagnosis (ABCD) Act, S. 1067, would eliminate financial barriers that prevent women from getting the vitally important diagnostic imaging tests needed to confirm the presence of breast cancer.

Credit: Photo by Anna Tarazevich from Pexels

Legislation introduced in the U.S. Senate would eliminate out-of-pocket costs for diagnostic mammograms, which, advocates say, could save lives by providing more equitable access to confirm the presence of breast cancer early.

U.S. Sens. Roy Blunt (R-MO) and Jeanne Shaheen (D-NH) introduced the Access to Breast Cancer Diagnosis (ABCD) Act.

The Susan G. Komen Foundation, a nonprofit advocating for breast cancer care and research, considers this and a similar state bill top legislative priority, Senior Director of Public Policy and Advocacy Molly Guthrie said.

"The federal bill deals with federally regulated private insurance and the state bill deals with state-regulated private insurance," Guthrie said.

State Bill 103, sponsored by Sen. Donzella James (D-Atlanta), is expected to return next legislative session.

"I think this is an issue that both Republicans and Democrats can get on board with," Guthrie said. "The idea is really that we want women to be diagnosed sooner, when their cancer is ideally easier to treat, but it also is less expensive on the health care system."


While private insurance provides access to free breast cancer screening via mammograms, diagnostic testing is needed to determine whether a biopsy is needed or cancer exists. These are tests such as ultrasound, MRI or diagnostic mammogram.

"Those exams can be extremely expensive and require high out-of-pocket costs — all before treatment even begins," Guthrie said.

About 12% of patients who receive annual screening mammograms get called back for diagnostic imaging. In Georgia, 8,770 women are estimated to be diagnosed with breast cancer in 2021 and 1,410 will die of the disease this year alone. Black women are 40% more likely than white women to die of breast cancer.

Dr. Veena Rao, professor of obstetrics and gynecology at Morehouse School of Medicine, has been studying the BRCA 1 gene since its discovery in 1994. Mutation of this gene leads to triple negative breast cancer, she said.

Type 2 diabetes and dense breasts are additional risk factors for Black women being diagnosed with breast cancer, Rao said.

Socioeconomic status plays a role, Rao said, because women without access to health care may not learn about the cancer until after it's had time to spread, at which time the cancers are more often deadly.

A woman who needed a diagnostic test after something suspicious appeared on her mammogram results put off her exam because of the cost, Guthrie said.

"Finally, I think six to eight months later, her cat jumped on her chest and it was just excruciating pain," Guthrie said. "So she went and took out a payday loan to be able to cover the $50 to get her her diagnostic imaging done. And then at that point was diagnosed with the later stage cancer that was more going to be more expensive for her to treat."

Guthrie said she shared that woman's testimony to show how out-of-pocket costs are barriers to care.

"Looking at equity between cancers, a person that's unfortunately subjected to colon cancer doesn't have to pay out-of-pocket costs once their test becomes a diagnostic," she said. "But for breast, there is this cost associated with it."

So a precedent exists for eliminating costs for diagnostic tests associated with breast cancer, Guthrie said.

In addition to support for the ABCD Act, Komen patient advocates this week called on lawmakers to prioritize:

  • Funding for the National Breast and Cervical Cancer Early Detection Program at $275 million in FY22. The program ensures access to early detection and breast cancer services for uninsured and underinsured Americans who do not qualify for Medicaid.
  • The Improving Social Determinants of Health Act (H.R.379/S.104), which will create a program within the U.S. Centers for Disease Control to improve analyze the social factors that affect our health, including housing conditions, employment status, food security, environmental safety, educational opportunity and medical racism, and fund programs to address them.