Insurance expansion for breast cancer screenings gets praise

NEW HAVEN — A bill to expand insurance coverage for breast cancer screenings took a big step forward late in the legislative session when state Rep. Gary Turco, D-Newington, accidentally locked Sen. Matt Lesser into his own office with a group of advocates working on the bill.

“We were all stuck in the room and had to hash it out,” said Lesser, D-Middletown and co-chairman of the legislature’s Insurance and Real Estate Committee.

The bill became a last-minute addition to the state budget at the end of session in June, and state legislators from both parties, advocates for women’s health and survivors of breast cancer held a press conference in support of the legislation Wednesday at Yale-New Haven Children’s Hospital.

The mandate eliminates co-payments, deductibles and out-of-pocket expenses of more than $20 for breast cancer screenings.

The federal Affordable Care Act requires insurance coverage for mammograms, but even 3D mammography cannot thoroughly examine dense breast tissue, breast radiologist Liane Philpotts said. Women with dense breasts are up to four times more likely to have breast cancer and need ultrasounds to detect the disease, but many decide not to have the ultrasound every year or at all because their co-pays or deductibles are too high, she said.

Nancy Cappello of Woodbury, who died of bone marrow cancer in 2018, was diagnosed with late-stage breast cancer in 2004, after two mammograms in two months had found nothing wrong.

She founded Are You Dense, Inc., an advocacy organization with the goal of educating the public about cancer risk and detection in dense breast tissue. According to the organization’s website, 40 percent of women have dense breast tissue, and they have less than a 48 percent chance of having breast cancer detected by a mammogram.

Breast cancer and dense breast tissue both appear white on a mammogram. Newington resident and breast cancer survivor Jan Kritzman said it was “like trying to find a snowball in a snowstorm” in her case.

Cappello inspired a 2009 state law, the first of its kind, requiring doctors to notify patients if they have dense breast tissue. Today 36 states and Washington D.C. have this law, and a federal requirement will go into effect next year.

Kritzman started receiving annual mammograms when she was 40 years old because of her family’s history of the disease, and she said the density reporting law led her to get an ultrasound in 2012 that found “a tiny, early-stage but very aggressive” breast cancer.

She testified in favor of the bill in front of the Insurance and Real Estate Committee in February and was one of the people who ended up locked in Lesser’s office.

“What’s a woman to do with all this notification if she can’t afford the follow-up testing?” Kritzman said.

House Minority Leader Themis Klarides, R-Derby, and Rep. Robyn Porter, D-New Haven, both said their support of the legislation comes partly from having dense breast tissue themselves.

“I’ve been fortunate. I’ve had the health care coverage to cover the costs (of ultrasounds), but I have many constituents that did not have that fortune.” Porter said. “It’s about leveling the playing field and making sure that we’re saving and valuing all lives.”

Lesser said early detection of cancer saved his own life. It also saves money in the health care system, Klarides said.

“I think we can all agree that the issue is education, knowledge, prevention and treatment, and hopefully we don’t have to get to the fourth one if we get enough of the first three,” she said.