Breast Cancer is the most commonly diagnosed cancer in the Commonwealth. Most insurance plans cover screening mammograms for women over 40 with no out-of-pocket costs under the ACA. However, screening does not provide a diagnosis. If it’s abnormal, or a patient feels a lump, they need at minimum special mammogram views and/ or an ultrasound to follow up. But there is no national law requiring health insurance to cover these diagnostic tests without cost-sharing. So some patients just don’t come back. And their cancers don’t go away-- they grow, spread, and become harder and more expensive to treat. Not everyone needs follow up testing. 10-12% of patients get called back for more testing after a screening. Less than half of those patients would need even more follow up or a biopsy. 10-15% of breast cancer is diagnosed in high-risk women. Supplemental screening with ultrasound or MRI is also not always 100% covered for women at high risk, or with dense breast tissue, despite recent guidance by the FDA, American Cancer Society, National Comprehensive Cancer Network, American College of Radiology, and the USPSTF. Some of these women can have an 80% chance of getting breast cancer in their lifetime and still forgo supplemental testing due to out of pocket costs. By a 2023 study, 1 in 5 of women would skip recommended imaging if faced with out-of-pocket costs. Another study showed that higher cost-sharing in insurance plans correlated with lower use of MRI, which actually boasts the highest cancer detection rates. This only widens the disparity gap: Black women are more likely to develop more aggressive cancers and 42% more likely to die of breast cancer than other racial or ethnic groups. These statistics are the lived experiences of real patients. As a breast radiologist serving Richmond for 17 years, and medical director of my practice, I hear too frequently missed appointments due to financial constraints. I see first-hand how these financial hurdles, especially for the underinsured or those with high-deductibles, can delay diagnosis and require treatments that in the long term far outweigh the cost of up-front imaging tests. One woman declined a diagnostic mammogram after her abnormal screening upon learning she would owe $1,500, not including the costs of any potential follow-ups. Another deferred a recommended biopsy for over a year; by then her cancer had tripled in size and spread, requiring more expensive testing and more aggressive and costly treatment. On the other hand, a 40-year-old mom received a stage 0 cancer diagnosis following additional imaging and biopsy from her 1st ever screening mammogram. Thanks to prompt follow-up testing, her prognosis was excellent, demonstrating the critical importance of accessible diagnostics. In fact I just saw her again for a checkup last month, 1 year after she was diagnosed, now cancer free and on her way out of town for the holidays. Over 20 states have passed laws like HB1828. And Virginia now has a similar law for colorectal cancer. There is a substantial body of scientific evidence that screening save lives. However, this only happens when next steps are taken to confirm a breast cancer diagnosis. Free screening but cost prohibitive diagnostics leave women in a precarious position regardless of advancements in technology or treatment. This reality exacerbates health disparities and inequities in our communities, a truth I witness daily.

As a woman with a high risk for breast cancer in Virginia, whose daughter shares that same risk, I am asking you to please vote in favor HB 1828. I know first hand the value of early detection and prevention. As a healthcare worker who works with women who share my same risk, I have watched patients agonize about whether to pursue the recommended additional screening or pay their mortgage. I have also held a patient who did not have the financial means to pursue additional screening as she was told she had an advanced stage of breast cancer that could have been caught at a much earlier stage. Virginia is one of seventeen states with breast cancer screening laws. This is not the side of the aisle we want to be on. I understand there is a cost associated with passing this bill. There is also a much greater cost with treating late stage breast cancer that would have had much less financial burden in an earlier stage. Cost has to be a consideration when budgets are in place I understand but what is a life worth? It’s priceless. I am asking you today to stand up for the women of Virginia who face this highest risk and say I see you and you are valued. Thank you for your time and consideration of this legislation. It means more to me and my family than you could imagine.

Breast Cancer is the most commonly diagnosed cancer in the Commonwealth. Most insurance plans cover screening mammograms for women over 40 with no out-of-pocket costs under the ACA. However, screening does not provide a diagnosis. If it’s abnormal, or a patient feels a lump, they need at minimum special mammogram views and/ or an ultrasound to follow up. But there is no national law requiring health insurance to cover these diagnostic tests without cost-sharing. So some patients just don’t come back. And their cancers don’t go away-- they grow, spread, and become harder and more expensive to treat. Not everyone needs follow up testing. 10-12% of patients get called back for more testing after a screening. Less than half of those patients would need even more follow up or a biopsy. 10-15% of breast cancer is diagnosed in high-risk women. Supplemental screening with ultrasound or MRI is also not always 100% covered for women at high risk, or with dense breast tissue, despite recent guidance by the FDA, American Cancer Society, National Comprehensive Cancer Network, American College of Radiology, and the USPSTF. Some of these women can have an 80% chance of getting breast cancer in their lifetime and still forgo supplemental testing due to out of pocket costs. By a 2023 study, 1 in 5 of women would skip recommended imaging if faced with out-of-pocket costs. Another study showed that higher cost-sharing in insurance plans correlated with lower use of MRI, which actually boasts the highest cancer detection rates. This only widens the disparity gap: Black women are more likely to develop more aggressive cancers and 42% more likely to die of breast cancer than other racial or ethnic groups. These statistics are the lived experiences of real patients. As a breast radiologist serving Richmond for 17 years, and medical director of my practice, I hear too frequently missed appointments due to financial constraints. I see first-hand how these financial hurdles, especially for the underinsured or those with high-deductibles, can delay diagnosis and require treatments that in the long term far outweigh the cost of up-front imaging tests. One woman declined a diagnostic mammogram after her abnormal screening upon learning she would owe $1,500, not including the costs of any potential follow-ups. Another deferred a recommended biopsy for over a year; by then her cancer had tripled in size and spread, requiring more expensive testing and more aggressive and costly treatment. On the other hand, a 40-year-old mom received a stage 0 cancer diagnosis following additional imaging and biopsy from her 1st ever screening mammogram. Thanks to prompt follow-up testing, her prognosis was excellent, demonstrating the critical importance of accessible diagnostics. In fact I just saw her again for a checkup last month, 1 year after she was diagnosed, now cancer free and on her way out of town for the holidays. Over 20 states have passed laws like HB1828. And Virginia now has a similar law for colorectal cancer. There is a substantial body of scientific evidence that screening save lives. However, this only happens when next steps are taken to confirm a breast cancer diagnosis. Free screening but cost prohibitive diagnostics leave women in a precarious position regardless of advancements in technology or treatment. This reality exacerbates health disparities and inequities in our communities, a truth I witness daily.

Please let me know about anything to do with ANY SOLAR or wind. Also why aren't you working on lowering this socialism health obamare that is failing! We pay double our house payment for healthcare. They do a certain percentage of what u make a year. I have to take money out of my 401k for healthcare that counts as income. It shouldn't count as income when you are taxing the heck out of us. We can't travel,most our prescriptions we use to take won't be covered and could go on and on about this robbery of people s hard earned money!

Early detection of breast cancer made the difference between life and death for me. HB1828 will make early detection through mammograms, MRIs, ultrasounds for all women. Costs should not be a barrier to detection or treatment, and this bill is extremely important to the lives of women.