Bills Would Require Private Insurers to Pay for Cancer Screening

Members of Congress are trying to assure coverage of cancer screening tests under private insurance plans that Congress equired Medicare to cover as part of the 1997 Balanced Budget Act. Reps. Carolyn Maloney (D-N.Y.) and Sue Kelly (R-N.Y.) introduced the Cancer Screening Coverage Act (H.R. 1285), which would require insurers to pay for breast, prostate, cervical, and colorectal cancer screening for all privately insured individuals. The insurance industry has been strongly opposed to these kinds of federal mandates; for example, it fought having to provide mental health coverage equal to physical health coverage and was successful in watering down congressional legislation along those lines.

Perhaps in acknowledgment of the political power of the insurance industry, Sen. Edward Kennedy (D-MA) and Reps. Louise Slaughter (D-N.Y.) and Connie Morella (R-MD) introduced the Eliminate Colorectal Cancer Act of 1999. The thinking is that insurers might be less likely to block this one-cancer bill than the broader Maloney/Kelly bill. Also, colorectal cancer strikes women and men at similar rates, as opposed to breast, prostate, and cervical cancers. So the Kennedy bill cannot be opposed on the grounds that it only helps half of the population. This bill would require insurance companies to pay for any of four options: fecal occult blood testing, flexible sigmoidoscopy, colonoscopy, or a double-contrast barium enema. The type of test that the patient would undergo and the frequency of testing would be left up to the physician and patient.

Some cancer groups may believe that the Kennedy bill hurts the Maloney/Kelly bill, but not Bernard Levin, MD, chair of an American Cancer Society colorectal cancer advisory group. “In no way does Sen. Kennedy’s bill detract or take away from the comprehensive legislative approach we traditionally use to advocate on behalf of cancer issues,” he says.