Texas health plans must now cover 3-D mammograms


AUSTIN (KXAN) — A new Texas law that went into effect this week requires health insurance companies to cover 3-D mammograms for women during cancer screenings.

Many health professionals say 3-D mammograms are more precise than traditional mammograms because doctors can look through each layer of tissue digitally, instead of only pictures. It could reduce the rate of false positives and allow for doctors to detect smaller groupings of cancer cells. The earlier breast cancer is detected, the easier it is to fight and has a drastic impact on whether a woman lives or dies.

Breast cancer specialists can now see what was hidden.

Dr. Debra Patt from Texas Oncology says with 3-D technology, she can look at 16 tissue images, instead of the two you get with 2-D. In looking through denser, often younger, tissue, she can detect cancer more easily.

“Women detecting breast cancer early makes it more likely they’re going to survive it, which is wonderful,” said Dr. Patt.

While 3-D has been available, she says many women went for the cheaper option. “So they would not have to have out of pocket costs,” Patt said.

“Breast cancer is so different in every single woman,” said Suzanne Stone from Susan G. Komen in Austin. She says it’s too early to tell if paying for the new technology will ultimately cost companies more or less, thanks to earlier detection and fewer false positives.

“I think it might but it’s going to be a while before we really see what that does,” said Stone.

Health advocates say this is a step forward but major hurdles remain. A spokesperson for Texas Medicaid told me they won’t offer 3-D and getting expensive equipment to rural clinics might be a challenge.

The American Cancer Society recommends women from 40 to 54 get annual mammograms. Those 55 and older should get one every two years. In Texas, there are four million women between 40 to 65 years old and just over half have insurance. For uninsured patients, a 2-D mammogram costs $250 — 3-D goes up to $350.

Texas lawmakers passed the law in 2017. During the legislative session, the Texas Association of Business registered against the bill in the committee process. In June, Jeff Moseley, CEO of TAB, sent a letter to state leaders stating the agency was against House Bill 1036 because “the cost of health insurance coverage is a primary concern for the members of TAB, we oppose all new health benefit mandates.”

Moseley goes on to say new mandates increases the costs for businesses and employers because this makes the 41st state mandate.

To that, the author of the bill, State Rep. Senfronia Thompson, D-Houston, says it will save the patient money instead of companies.

“Cancer doesn’t know any particular person. It doesn’t know any particular ethnicity. It doesn’t know any particular social economic status. It touches any and everyone,” said Rep. Thompson.

To find out more about getting a mammogram, click here. 

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