BISMARCK, N.D. -- As North Dakota legislators close their first week of business for the new year, American Cancer Society Cancer Action Network advocates on Monday will ask them to take strong action to reduce the cost of fighting cancer.
ACS CAN volunteers look forward to meeting with lawmakers and urging them to pass important legislation around prescription drug copay accumulator adjustments and supplemental breast cancer imaging during ACS CAN’s Day at the Capitol.
“North Dakota patients should not face large out-of-pocket costs to detect breast cancer early,” said Rep. Karen Karls, who is sponsoring House Bill 1216 on co-pay accumulators and is planning to sponsor the proposed legislation on supplemental imaging as well. “Early detection saves lives and money and other states that have done this, like Montana, have found that the finances make sense.”
Mammograms are an invaluable tool in detection of breast cancer. North Dakota is doing relatively well in this regard, with 72% of women 40-plus reporting a mammogram in the past two years, ranking 17th among the 50 states and Puerto Rico. That number climbs to better than 80% with women 50-plus, 10th in the nation.
But not all North Dakotans get all they need from mammograms and many require follow-up testing because of an abnormal finding on a screening mammogram or supplemental imaging because of certain risk factors. The steps needed for full peace of mind can cost thousands out of pocket. These patients are often put in position of choosing between a full medical workup or paying for a month’s worth of groceries.
The proposed legislation would require all state-regulated health policies to eliminate patient out-of-pocket costs for medically necessary diagnostic and supplemental breast imaging. It would require breast diagnostic mammograms (x-rays), breast ultrasounds, and breast magnetic resonance imaging (MRI) scans be covered by insurers at no-cost-share when deemed medically necessary by their physician. It would allow North Dakotans to complete the full continuum of breast cancer screening without having to make excruciating financial choices about basic daily needs over their long-term health.
Advocates will also ask lawmakers to provide better access to prescription drugs by passing copay accumulator adjustment legislation. Passing this legislation will require all prescription drug copayments made by patients, directly or on their behalf, to count toward their overall out-of-pocket maximum or deductible, making cancer treatment more affordable and saving some North Dakotans from additional medical debt. A 2022 ACS CAN study found 31% of cancer patients and providers noted paying for prescriptions as a challenge and 20% indicated that financial considerations had caused them to skip or delay taking prescribed medication.
“We need insurers to count copay assistance paid by or on behalf of an enrollee toward their annual deductibles and out-of-pocket limit to allow North Dakotas life-saving drugs,” Karls said. “This bill would be a step toward easing that problem.”
ACS CAN encourages individuals, businesses and organizations that are interested in getting involved in the fight against cancer to visit https://www.fightcancer.org/states/north-dakota