COLUMBIA, S.C. – A new report by the American Cancer Society Cancer Action Network (ACS CAN) found that over 70% of commercially-insured patients had out-of-pocket costs for follow-up breast cancer diagnostic tests in 2023. These follow-up tests, including diagnostic mammograms, MRIs, ultrasounds or biopsies, are medically recommended next steps to determine if an individual has cancer. However, barriers like cost can keep people from getting them.
While screening mammograms are free to most insured women starting at age 40, follow-up testing often results in out-of-pocket cost sharing for patients. The new report shows South Carolina ranks sixth-worst of any state, with patients taking on an average of 43.1% of the costs.
“Nearly 6,000 women will get breast cancer in South Carolina in 2025,” said Beth Johnson, regional government relations director for ACS CAN in South Carolina. “Each one of these women deserves to have the tests they need, without cost barriers, so they can catch and treat cancer early, leading to better survival rates. We applaud Rep. Sylleste Davis for sponsoring a critical bill to eliminate these costs and save lives.”
Rep. Davis has introduced HB 3202 to require health insurance providers to provide diagnostic and supplemental breast examination coverage without cost-sharing requirements.
“Cost should not impact anyone’s chances to treat or survive cancer,” Rep. Davis said. “However, the threat of these high costs keep women from getting the imaging they need.”
Delaying or skipping follow-up diagnostic tests can result in later-stage cancer diagnoses and higher healthcare costs. In 2024, more than 1 million women were estimated to experience a delay in follow-up testing and imaging due to associated costs. The report also determined nearly 400,000 women were likely to skip future mammograms due to fear of out-of-pocket costs from follow-up diagnostic tests.
The report showed the elimination of out-of-pocket cost sharing for follow-up tests could save the U.S. an estimated $2.2 billion in lifetime breast cancer treatment costs.