Consumer / Employer, Payers

Report: 22.2M Women Could Lose Access To Free Mammogram Screenings

A recent court decision could lead to women losing access to free mammogram screenings, a new Urban Institute report showed. Without insurance, mammograms can cost up to $560 in out-of-pocket expenses.

The March 30 Braidwood v. Becerra decision strikes down a part of the Affordable Care Act (ACA) that prevents cost sharing for some preventive services, which potentially includes mammogram screenings for breast cancer. This means 22.2 million women between the ages of 50 and 64 could lose access to free mammogram screenings, a new Urban Institute report found.

The court decision “invalidates” recommendations from the U.S. Preventive Services Task Force from 2010 to the present, the Urban Institute said. In 2009, Mammograms were recommended for women aged 50 to 74.

“They would appear to be unaffected by the Braidwood ruling,” the researchers said. “However, the guidelines regarding mammograms have been updated since 2010. Whether the ruling also applies to recommended services that have been updated since 2010, which would include mammograms, is uncertain.”

The report, published Wednesday, was conducted by the Urban Institute with support from the Robert Wood Johnson Foundation. It relied on the 2018 Medical Expenditure Panel Survey Household Component, a nationally representative survey, to conduct the analysis.

The Urban Institute found that in 2018, 22.2 million women between 50 and 64 years old were enrolled in a private health plan and were eligible for a free mammogram. Of these women, 13.4 million (more than 60%) reported they had a mammogram in the previous two years.

“Eliminating access to no-cost preventive screenings for breast cancer and other serious diseases would be a major step backward,” said Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation, in a news release. “Under the protections of the Affordable Care Act, millions of women benefited from life-saving mammogram screenings as a routine part of preventive healthcare, and they should continue to do so. Policymakers should protect preventive health screenings at no cost to patients.”

Without insurance, mammograms can carry a hefty price tag. These screenings can cost up to $560 in out-of-pocket expenses, the report noted.

“Recent litigation has put many women at risk of losing access to mammograms. Given the high cost of mammograms not covered by insurance, cost could become a significant barrier to care for women with fewer financial resources,” said Claire O’Brien, Urban Institute research analyst, in a statement.

About 2.4 million, or 11%, of the women surveyed already said they delayed or skipped care because of healthcare costs in the prior year. In addition, the report cited another recent survey that found that 38% of adults would not pay out-of-pocket for cancer screenings.

“If the out-of-pocket cost of a mammogram were to increase, it is likely that women’s compliance with recommended screenings would fall,” the researchers said in the report. “For many women ages 50 to 64 with private insurance, cost was a barrier to care more generally.”

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