Research has shown that breast cancer screenings with mammograms reduce the number of deaths from breast cancer for women ages 40 to 69, especially for those over age 50.1 The CDC’s National Breast and Cervical Cancer Early Detection Program covers mammograms for certain categories of underserved women.2 However, states should require that private insurers cover mammograms, thereby giving all women access to this screening.
Health plans are required to cover, without copayments, the preventive services recommended by the United States Preventive Services Task Force (USPSTF), including annual mammograms for women age 40 and over. 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.
States that require private insurers to cover annual mammograms for women age 40 and older3 are considered to have comprehensive breast cancer screenings and therefore receive a "meets policy." States receive a "limited policy" if they require private insurers to cover annual mammograms for women age 50 or older, or "if required by a physician." States receive a "weak policy" if they only require insurers to offer mammogram coverage as a benefit in health insurance plans, but have not required that it be a mandated benefit in insurance plans. States that do not have any requirements regarding insurance coverage for mammograms receive a "no policy."
|State||Strength of Policy||Change from 2007|
|District of Columbia||Meets Policy||Same|
|New Hampshire||Limited Policy||Same|
|New Jersey||Meets Policy||Same|
|New Mexico||Limited Policy||Same|
|New York||Limited Policy||Same|
|North Carolina||Limited Policy||Same|
|North Dakota||Meets Policy||Same|
|Rhode Island||Meets Policy||Same|
|South Carolina||Meets Policy||Same|
|South Dakota||Limited Policy||Same|
|West Virginia||Limited Policy||Same|
Data Source: National Women's Law Center, unpublished data, collected March-June 2010.
1 National Cancer Institute, “Mammograms,” August 2009, available at http://www.cancer.gov/cancertopics/factsheet/Detection/mammograms, accessed September 24, 2010.
2 “An estimated 8%–11% of U.S. women of screening age are eligible to receive NBCCEDP services. Federal guidelines establish an eligibility baseline to direct services to uninsured and underinsured women at or below 250% of federal poverty level; ages 18–64 for cervical screening; ages 40–64 for breast screening.” U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, “National Breast and Cervical Cancer Early Detection Program: About the Program,” December 3, 2009, available at http://www.cdc.gov/cancer/nbccedp/about.htm, accessed September 24, 2010.
3 The Report Card uses annual screenings for women age 40 and older as its standard to determine whether states meet the policy because it is the age at which the American Cancer Society recommends women begin annual mammograms. American Cancer Society, “Guidelines for the Early Detection of Cancer,” 2010, available at http://www.cancer.org/Healthy/FindCancerEarly/CancerScreeningGuidelines/... April 1, 2010.