New state law covers mammogram many women couldn't afford

State Representative Diego Bernal sponsored HB 170

TEXAS – Diagnostic mammograms are now fully covered under state-regulated medical insurance plans and Medicaid. State Rep. Diego Bernal filed HB170 for three years until it finally became law on Sept. 1 of this year.

The purpose behind the law is to get rid of the economic barrier patients may experience when needing a diagnostic mammogram.

"What the law does is, it covers a diagnostic mammogram in full the way that the screening mammogram is covered in full," Bernal said.

How does age play a role in breast cancer risk?

When a patient has a lump in their breast or shows other signs of breast cancer, it's common for physicians to skip a screening mammogram and proceed to a diagnostic mammogram.

According to Dr. Kenneth Kist, director of Breast Imaging at UT Health and radiologist with University Health System, the difference between the two procedures is the detail of the X-ray.


5 ways to stay healthier, possibly decrease breast cancer risk

"The images that we obtained for a diagnostic mammogram are more focused to the area of concern to the finding that we saw in the screening mammogram or the specific physical exam finding with the patient or the patient's physician found," Dr. Kist said.

However, according to a study released by the organization Susan G. Komen, cost can be the first hurdle for a patient.

"The idea that someone's first mammogram has a $300 up to a $1,000 out-of-pocket expense can be deadly," Bernal said. "In our city, especially on the West Side and Southside, breast cancer is the number one leading cause of cancer deaths in our city and in the state."


Sisters diagnosed with breast cancer weeks apart

Although the law doesn't pertain to national medical insurance plans or to patients without insurance, it makes it easier to explore options to cover medical expenses through the help of organizations.

"Organizations like Susan G Komen can spend that money helping people who don't have insurance at all. That's something we still have to work on in Texas. It shouldn't be that you need insurance to have your life saved," Bernal said.

For more information on local resources in Bexar County, click here to visit Susan G. Komen's website.

About the Authors: