"Michelle's Law"; requires health benefit plans to cover mammogram for an individual if recommended by health care provider.
The enactment of S1330 is expected to have a considerable impact on state laws regarding women's healthcare, specifically breast cancer screening. By ensuring coverage for younger women who may be at risk, the law will likely promote earlier detection of breast cancer, which is crucial given the disease's high survival rate when diagnosed early. Additionally, the bill seeks to align health insurance plans with the recommendations of healthcare providers, ensuring that patients can receive necessary medical services without financial barriers.
'Michelle's Law' honors Michelle DeVita, a woman whose tragically untimely death due to breast cancer highlighted the gaps in existing insurance coverage. The framing of the bill within this personal story is expected to bolster its support among legislators and advocacy groups focused on improving women's health outcomes and access to essential screenings.
Senate Bill S1330, dubbed 'Michelle's Law', aims to mandate health benefit plans to cover the cost of a mammogram examination if recommended by a healthcare provider. This is a significant expansion of coverage from existing requirements, where health benefit plans only need to provide coverage for women aged 40 and older or those under 40 with a family history of breast cancer. The bill stipulates that women under 40 can now receive coverage for mammograms based on medical necessity determined by their providers, which is a broader criterion than currently permitted.
However, there may be points of contention surrounding the financial implications of this legislation. Critics may argue that mandating coverage could increase overall healthcare costs for insurers, which could in turn lead to higher premiums for all policyholders. Opponents may also express concerns about the scope of coverage and the effectiveness of insurer practices, particularly regarding utilization reviews that determine the necessity of additional screenings recommended by medical professionals.