Congresswoman to sponsor bill modernizing Women’s Health and Cancer Rights Act

There is new hope for women diagnosed with breast cancer but denied coverage for surgeries after a mastectomy.

Efforts to update the Women’s Health and Cancer Rights Act are well underway.

“Specifically, this law will say that these procedures and these types and modalities of treatment should be covered,” explained Dr. Alicia Billington, a plastic and reconstructive surgeon in St. Petersburg.

WATCH: FL Congresswoman to sponsor bill modernizing federal law protecting women after breast cancer

For years, Dr. Billing has been working with other advocates from the American Society of Plastic Surgeons to modernize the federal law.

Originally passed in 1998, the law is supposed to provide protections to patients who choose reconstruction surgery after a mastectomy.

But nearly 30 years later, advancements in surgeries and treatments have paved the way for insurance loopholes and denials for many patients.

“Every person in the United States can understand that someone who has breast cancer, should get their care covered,” Dr. Billington said.

Last week, Dr. Billington and other members from the American Society of Plastic Surgeons made their annual pilgrimage to the nation’s capital in hopes of garnering support for a new bill aimed at modernizing the federal law with new protections for all kinds of breast cancer-linked surgeries, from implants and tissue-based reconstruction to lumpectomies.

The updated law would be known as the Women’s Health and Cancer Rights Act of 2023.

“It takes into account new treatments that we've been using for years that aren't really new but weren't necessarily covered in the old bill,” explained Billington.

Earlier this year, we shared the stories of Florida breast cancer patients who were denied insurance coverage for treatments and procedures that their doctors recommended.

Many of the women we spoke with as part of our series, Patient No More, also shared the insurance denials they faced during the reconstruction process of their cancer journeys.

“They were only going to cover the cancerous breast, they would not cover the non-cancerous breast mastectomy,” Ashely Fox told us at the time.

Dennisse Carrion waited more than a year for her reconstructive surgery because halfway into her reconstructive process, she said her surgeon was dropped by her insurance company, making him an out-of-network provider.

Florida Congresswoman Kat Cammack of Alachua County has signed on to sponsor a bill in the U.S. House of Representatives. Supporters are still looking for a sponsor in the United States Senate.

“For too long, the Women’s Health and Cancer Rights Act has been stuck in the 1990s—failing to keep pace with medical innovation and the diverse needs of today’s breast cancer patients. That’s why I’m proud to lead this bipartisan effort to modernize the law and ensure women have full access to medically necessary, life-changing reconstructive care,” Cammack said in a statement.

Dr. Billington said Representatives Debbie Dingell from Michigan, Beth Van Dyune of Texas, and Representative Lucy McBath of Georgia have also agreed to lend their support to the bill.

In response to the anticipated bill, a spokesperson from AHIP, a trade organization for the health insurance industry, said, “while the vast majority of claims are approved, insurers are continuing to work with providers to improve our fragmented health care system and deliver a more seamless patient experience, including by abolishing error prone manual processes and decisively move away from fee-for-service to care models that are outcomes-based and patient-centric.”

Earlier this summer, several major insurers also announced they were voluntarily speeding up or reducing the pre-authorization process that so often slows down patient care, including patients recovering from breast cancer.

“People are so angry, and people are so over it,” said Billington who believes modernizing the federal law would be a huge step in the battle against breast cancer and making women who are fighting on the frontlines feel whole again.

“Don't underestimate a lot of angry women,” she said.