For the first time in the history of Susan G. Komen, the organization filed its own amicus brief because of the potential impact on millions of people who may need access to affordable breast cancer risk reduction and early detection services. In 2023 alone, more than 300,000 people in the U.S. will be diagnosed with breast cancer and nearly 44,000 are expected to die from the disease.
This litigation threatens the coverage of preventive services recommended by the U.S. Preventive Services Taskforce, which currently come at no cost to individuals. The Affordable Care Act (ACA) requires insurers to cover the full cost of breast cancer screening mammograms, genetic counseling and testing for women who may be genetically predisposed to cancer, and medications that can lower one’s risk of developing cancer.
In March, a U.S. District Court ruled that insurers do not have to cover the full cost of some preventive breast cancer services, which will limit access and make these life-saving services unaffordable, if the ruling goes into effect. The result will undoubtedly be breast cancer being found at more advanced stages when treatment options are limited and outcomes are poorer. For these reasons, Komen respectfully requests that the Appeals Court rule against the District Court’s judgment.
Komen argues in its brief that preventive care measures “can help identify and reduce one’s risk of breast cancer and detect the disease years before signs and symptoms develop. Risk reduction and early detection measures enable individuals and their care providers to fight breast cancer earlier, when more treatment options and better outcomes are possible.”
“One of the greatest outcomes from the ACA has been that barriers to care were removed for millions of people, coast to coast. This short-sighted ruling from the District Court threatens to make preventive care unattainable for many in the community Komen serves,” said Molly Guthrie, Vice President of Public Policy and Advocacy at Komen. “We cannot afford to lose ground in our fight to make care accessible to those most at risk for disparities in breast cancer outcomes, including communities of color, those living in rural areas, and those under financial distress. People’s lives and their quality of life are at risk.”
In its brief, Komen aims to assist the Court in understanding the importance of the ACA’s requirement that insurers cover breast cancer-related preventive measures, as recommended by the U.S. Preventive Services Task Force, such as breast screenings, genetic testing and counseling, and medications that can lower one’s risk of developing breast cancer.
“Studies show that the ACA’s elimination of the cost-sharing for these types of services has had a profound impact on public health because such preventive care translates to earlier detection, earlier treatment, lower treatment costs and fewer deaths from breast cancer,” said Guthrie. “Forcing individuals to pay a portion of the cost for these services could reverse years of progress on prevention, early detection and disease management that the ACA provisions in question have made in reducing the physical and financial burden of treating severe illnesses in this country by reducing the cost to the individual and the U.S. health care system as a whole.”
On behalf of the millions of patients Komen serves, we continue to advocate for the Fifth Circuit to uphold the rights of individuals’ access to no-cost, evidence-based preventive services as required under the ACA.