Edly-Allen measure to expand breast cancer care

SPRINGFIELD - State Senator Mary Edly-Allen passed an initiative through the Senate Insurance Committee to fill gaps in current breast cancer screening coverage and ensure that all Illinoisans are able to receive screening that accurately detects cancer.

"Standard mammograms aren't always effective on patients with dense breasts. Unfortunately, insurance companies may deny having additional tests that are needed to detect cancer. This can lead to life-threatening situations for those who cannot afford additional tests," said Edly-Allen (D-Libertyville). "We must ensure that we do not put profit over people's health and require these insurance plans to cover all medically necessary tests, and not just the bare minimum."

House Bill 4180 would require any insurance plan in the state, including Medicaid, to cover molecular breast imaging (MBI) and magnetic resonance imaging (MRI) if a mammogram demonstrates heterogeneous or dense breast tissue or when determined medically necessary.

Currently, insurers must provide coverage for screening by low-dose mammography for all women 35 years of age or older for the presence of occult breast cancer. The proposed legislation would add MRI and MBI coverage if medically deemed necessary so that all plans align.

"If we are committed to making good healthcare available at an affordable price to everyone, effective breast cancer screenings have to be part of the effort. However, millions of patients with dense breasts are being forced to live with screening options that don't work for them. For the health of those patients, medical coverage must expand to include Molecular Breast Imaging," said State Representative Nabeela Syed (D-Palatine). "Leslie Yerger, founder and CEO of a local nonprofit, brought this issue to my attention after she lived nearly a decade without receiving the screening she needed. We cannot stand by and let cases like hers happen again."

House Bill 4180 passed the Senate Insurance Committee on Tuesday and now heads to the full Senate for further consideration.