Health care costs are squeezing American families, and for many people, that pressure is hitting at the worst possible moment – when they need answers about breast cancer. The question isn’t whether screening saves lives. It’s whether patients can afford to follow through. A simple fix could change that: ensuring access to breast cancer imaging without out-of-pocket costs.
That’s why advocates from across the country are heading to Capitol Hill to push for change, calling for leadership on a bill that could improve access and save lives – the Access to Breast Cancer Diagnosis (S.1500/H.R. 3037), or ABCD, Act.
The ABCD Act requires private health plans to cover diagnostic and supplemental breast imaging – fully, with no out-of-pocket cost to patients. This federal legislation ensures that more people get the timely diagnoses they need.
During their time in Washington, D.C., Alliance for Breast Cancer Policy member organizations—including the American Cancer Society Cancer Action Network, TOUCH: The Black Breast Cancer Alliance and METAvivor—worked in concert to advance the ABCD Act by sharing firsthand accounts of how coverage gaps harm patients in their communities.
This partnership is driven by a simple truth: patients deserve timely answers. While passage of the ABCD Act would bring reassurance to countless individuals, today’s reality is far different. Patients often encounter an expensive diagnostic process that can delay care.
Consider a patient who visits their doctor for a routine breast cancer screening and receives an abnormal finding. Their physician recommends additional imaging to determine a diagnosis. Under the status quo, the additional diagnostic imaging, such as an MRI or ultrasound, often comes with unexpected out-of-pocket costs that make timely follow up care difficult.
Now consider a patient who is at high risk for breast cancer, either due to family history, a genetic mutation or perhaps dense breast tissue who requires supplemental imaging. Even though supplemental imaging is deemed medically necessary, insurance coverage will often fall short in a patient receiving the care they need when they need it the most, often costing patients hundreds or even thousands of dollars in out-of-pocket expenses.
We know that early detection and treatment can save lives. In the U.S. alone, an estimated 43,000 women and men lost their lives to breast cancer in 2025. Yet patients continue to face financial burdens to receive the medically necessary imaging that makes early detection possible.
That urgency is what brought advocates to Capitol Hill, where they met with congressional offices to highlight how federal policy can close gaps in care – a call to action already echoing across the country.
To date, 32 states have enacted laws eliminating patient cost sharing for diagnostic and/or supplemental imaging for some state-regulated plans. By enacting these bipartisan policies, states are closing gaps in lifesaving care, and evidence from multiple states shows that the resulting impact on premiums has been negligible.
While state leadership has proven both effective and fiscally responsible, where a patient lives – or the type of health plan they carry – should not determine whether he or she can afford a timely breast cancer diagnosis. Millions of Americans are covered by federally regulated health plans that fall outside state reforms, leaving gaps in access to care. The ABCD Act would close those gaps nationally, ensuring that cost is no longer a barrier to diagnosis and helping address persistent disparities that disproportionately affect Black, Hispanic rural and lower-income patients.
These disparities are a predictable result of a system that places cost barriers between patients and timely diagnosis. The evidence is clear: high out-of-pocket costs prevent patients from obtaining recommended imaging – allowing breast cancer to spread and making it far deadlier and more costly to treat.
Smart, evidence-based policy solutions like the ABCD Act can improve outcomes, reduce longstanding disparities, contain costs to the system, and ensure patients receive answers when they need them most.
By eliminating cost barriers and restoring decision making to patients and providers, Congress can align federal policy with what states across the country have already proven works.
The time to act is now – because cost should never be a barrier to early detection.
Molly Guthrie is vice president of policy and advocacy at Susan G. Komen.
