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Colorectal Cancer Screening

Although colon cancer is the second largest cancer killer in America,1 it has one of the highest survival rates with early detection and treatment.2 In order to detect colorectal cancer, the American Cancer Society recommends that all individuals over 50 get screened, either through a sigmoidoscopy or a colonoscopy.3 States can expand access to this important preventive screening by requiring coverage in private insurance.

Health plans are required to cover, without copayments, the preventive services recommended by the United States Preventive Services Task Force (USPSTF), including colorectal cancer screenings. This provision took effect in September 2010. Additionally, the list of free required preventive services will be updated in 2011 to ensure that services women in particular need are included. "Grandfathered" plans--those that existed before the Affordable Care Act was passed--are exempt from this requirement, but plans will lose their grandfathered status if they significantly cut benefits, increase out-of-pocket spending, or change insurance carriers.

Does the state require private insurers to cover colorectal cancer screening?

States receive a "meets policy" if they require private insurers to cover colorectal cancer screening in either individual or group health insurance policies.  States receive a "no policy" if they do not require coverage of colorectal cancer screening.

State Strength of Policy Change from 2007
Alabama 4 No Policy Same
Alaska Meets Policy Same
Arizona No Policy Same
Arkansas Meets Policy Same
California 5 No Policy Same
Colorado Meets Policy Better
Connecticut Meets Policy Same
Delaware Meets Policy Same
District of Columbia Meets Policy Same
Florida No Policy Same
Georgia Meets Policy Same
Hawaii No Policy Same
Idaho No Policy Same
Illinois Meets Policy Same
Indiana 6 Meets Policy Same
Iowa No Policy Same
Kansas No Policy Same
Kentucky Meets Policy Better
Louisiana Meets Policy Same
Maine Meets Policy Better
Maryland Meets Policy Same
Massachusetts No Policy Same
Michigan No Policy Same
Minnesota Meets Policy Better
Mississippi No Policy Same
Missouri Meets Policy Same
Montana No Policy Same
Nebraska Meets Policy Better
Nevada Meets Policy Same
New Hampshire No Policy Same
New Jersey Meets Policy Same
New Mexico Meets Policy Better
New York No Policy Same
North Carolina Meets Policy Same
North Dakota No Policy Same
Ohio No Policy Same
Oklahoma 7 No Policy Same
Oregon Meets Policy Same
Pennsylvania Meets Policy Better
Rhode Island Meets Policy Same
South Carolina No Policy Same
South Dakota No Policy Same
Tennessee 8 No Policy Same
Texas Meets Policy Same
Utah No Policy Same
Vermont Meets Policy Better
Virginia Meets Policy Same
Washington Meets Policy Better
West Virginia Meets Policy Same
Wisconsin No Policy Same
Wyoming Meets Policy Same

Policy Indicator Counts
Meets Policy: 
29
Limited Policy: 
0
Weak Policy: 
0
No/Harmful Policy: 
22
Better: 
9
Same: 
42
Worse: 
0

Data Sources: 1) National Conference of State Legislatures, "Colorectal Cancer Screening: What are States Doing?" September 2010, available at http://www.ncsl.org/default.aspx?tabid=14328, accessed Septmeber 10, 2010; 2) Laudicina, Susan S., et al, State Legislative Healthcare and Insurance Issues (Washington, D.C.: BlueCross BlueShield Association, December 2009).

Footnotes

1 Centers for Disease Control and Prevention, “Fast Facts About Colorectal Cancer,” March 8, 2010, available at http://www.cdc.gov/cancer/colorectal/basic_info/facts.htm, accessed September 24, 2010.

2 Colon Cancer Alliance, “Screening Can Reduce Your Risk!,” 2010, available at http://www.ccalliance.org/screening.html, accessed September 24, 2010.

3 American Cancer Society, “American Cancer Society Guidelines for the Early Detection of Cancer,” March 3, 2010, available at http://www.cancer.org/docroot/ped/content/ped_2_3x_acs_cancer_detection_..., accessed September 24, 2010.

4 In Alabama, though private insurers are not required to provide coverage for colorectal cancer screening, they are required to offer such coverage as an option for policyholders.

5 In California, private insurers are required to cover colorectal cancer screening in Medicare supplement policies only.

6 In Indiana, group health plans are required to provide coverage for colorectal cancer screening, but private insurers are only required to offer such coverage as an option in individual health plans.

7 In Oklahoma, though private insurers are not required to provide coverage for colorectal cancer screening, they are required to offer such coverage as an option for policyholders.

8 In Tennessee, though private insurers are not required to provide coverage for colorectal cancer screening, they are required to offer such coverage as an option for policyholders.

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