Up to 17M women could lose mammogram coverage

HHS is considering adopting guidance from an independent panel of medical experts that recommends against regular mammograms for women under 50 unless they are at acute risk for breast cancer. If this guidance is adopted, insurance companies will no longer be required to cover biennial mammograms for women under 50, according to The Hill.

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This new guidance would affect at least 17 million women between the ages of 40 and 49, according to analysis by Avalere Health. The vast majority of these women have health insurance through employer plans, while 1.2 million are covered under the Patient Protection and Affordable Care Act insurance exchanges and 1.1 million by Medicaid expansion, according to the report.

A similar recommendation was issued in 2009. Both received fierce backlash, though some groups, such as the American Cancer Society against Breast Cancer Action, have held fast to the belief that routine breast cancer screenings for women under 50 are unnecessary and do not reduce cancer deaths. In a recent op-ed in the Washington Post, Karuna Jaggar, executive director of Breast Cancer Action, purported the idea biennial mammograms save lives is “founded more on politics and profit than in science.”

More articles on payer issues:
HHS says insurers required to cover all contraceptives: 3 things to know
WellCare posts better-than-expected profit
Insurers now cover most visits to CVS, Walgreens clinics

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