By KATIE BRUELL
Los Alamos

For years we’ve gone to our regular mammogram appointments (preventive medicine, covered 100% by our health insurance) only to be told, “You have (radiographically) dense breast tissue. We can’t really say whether or not you are developing breast cancer without a breast ultrasound.” Then we turn to our health insurance, which tells us, “A breast ultrasound is diagnostic, not preventive, so you’ll need to pay out of pocket for that.” Many of us don’t have the thousands of dollars a breast ultrasound costs, so we’ve been left wondering–is there cancer developing? Would I know before it was too late?

Thanks to House Representatives Christine Chandler, Liz Stefanics and Liz Thomson, we don’t have to wonder and worry anymore. Their legislation to mandate insurance coverage of breast ultrasounds and MRIs, House Bill 27, passed in the 2023 legislative session and became law Jan. 1, 2024. 

Despite this, there is widespread unawareness that anything has changed. Yesterday I called two providers of ultrasounds, and both told me I’d need to cover the full cost if my doctor had coded the test as diagnostic on her orders. One provider quoted me a price of $3,000 to get this medically necessary preventive screening done. My doctor’s office also didn’t know that laws had changed–in fact, the nurse I spoke to said that she herself has dense breast tissue and wasn’t able to afford an ultrasound even though her doctor told her she needed one. 

Finally, I called my insurance company. After an hour on hold while various representatives did research into the issue, I was given a letter that stated that my coverage for a breast ultrasound is 100%, with no deductible or copay. The representative who solved this issue even called the provider I’d like to see and told them that yes, this was truly covered at $0 to me, just like a mammogram.

This issue is important to me–three of my four aunts have had breast cancer, and a St. John’s classmate, Hallie Leighton, died at 42 from breast cancer that went undiagnosed until it was too late. The culprit? Her dense breast tissue. (You can read more about her here.)

I am deeply grateful to Reps. Chandler, Stefanics and Thomson for understanding the critical nature of this issue and working hard to change the system that denies women healthcare they need. I hope that, because of this work, other dense-breasted women like me start getting this life-saving preventive care.