Bipartisan bills in the Kansas Statehouse to eliminate copays on diagnostic or supplemental breast exams for insured people fell short this legislative session. Supporters of the legislation say they are angry by the lack of action.
Many other Midwestern states, like Colorado, Oklahoma and Missouri, have already signed similar legislation into law. Rep. Linda Featherston, a Democrat whose district covers parts of Johnson County, said she’s frustrated seeing the legislation fail.
“We just seem determined to be the last state to do the right thing for our citizens,” she said. “That's just bullheaded stubbornness, and it's wrong.”
Featherston sponsored one of the bills this year. When it died in committee, she fought to add an amended version to the budget to cover copays on supplemental screening for state employees. That was killed, too.
Most insured Kansans can get annual, complimentary mammograms to screen for breast cancer. If someone needs extra or more complicated screening, they’ll have to foot the bill. Advocates say some people put off additional screening because they can’t afford it, which can be dangerous and costly.
The push to expand breast cancer care
The Susan G. Komen Breast Cancer Foundation has been pushing Kansas lawmakers since 2020 to eliminate copays for diagnostic and supplemental breast exams.
“Kansas is actually one of the states that we've been working in the longest,” said Molly Guthrie, Susan G. Komen vice president of policy and advocacy. “Since we've been working on this legislation to get it passed in Kansas, we've seen more than 15 states introduce and pass the legislation.”
Guthrie, who lives in Wichita, said lawmakers are doing a disservice to the state by not codifying this legislation into law.
“Policy takes time, I get that. It’s just disappointing. As a Kansan, it's disappointing to me personally,” she said.
Mammograms, according to Guthrie, are not a one-size-fits-all scenario. Sometimes, people need more than an annual screening. If a doctor finds something they are concerned about, they’ll call the patient back for additional diagnostic imaging.
“That could be a diagnostic mammogram, it could be a breast ultrasound, it could be a breast MRI,” Guthrie said. “Those are the three most common modalities today.”
Guthrie said diagnostic imaging is an essential part of getting to the next step: determining whether the person needs a biopsy.
When a person can’t get a routine mammogram, they need what’s called “supplemental imaging” to screen for breast cancer. Guthrie said people with high breast cancer risk factors or a certain breast density or people who are breast cancer survivors generally have to use supplemental imaging, like an MRI or ultrasound, which are more sensitive, in lieu of a mammogram.
“Technology has advanced that we know that mammography isn't the best for every person,” she said. “But insurance and health policy hasn't kept pace with that advancement.”
Guthrie said diagnostic and supplemental screening can cost as low as $25 and as high as thousands of dollars. She said there’s a correlation between a late-stage diagnosis and people not being able to afford these costs. Guthrie said a late-stage diagnosis typically leads to more aggressive, expensive treatment.
“And if you delay it too long, you have the chance of being diagnosed once your breast cancer has left your breast,” she said. “So you're now stage 4 breast cancer and metastatic disease. And that means that you'll be in treatment for the rest of your life.”
Featherston’s story
Featherston has firsthand experience with breast cancer and the costs associated with it. In 2022, the year she was elected to her second term as a representative for Kansas' District 16, she was diagnosed with stage 1 breast cancer.
“I'd actually put my mammogram off until after the election because I just couldn't deal with one more thing on my calendar,” Featherston said.
When she got the news, Featherston said she immediately thought of her constituents.
“One of my first thoughts was, ‘What will I do to take care of my seat in the House?’” she said. “Like, these people put their faith in me to continue to represent them. And I just … I don't even know what lies ahead of me.”
Featherston said around the same time, when she was grappling with how to tell her colleagues at the Statehouse about her diagnosis, she was approached by a Susan G. Komen lobbyist who asked for her support on legislation to help reduce the costs of screening.
“I just thought, you know, things happen for a reason,” Featherston said. “If I could use my bad fortune to help others, then something good could come out of my situation.”
Featherston told other lawmakers covering copays for diagnostic and supplemental breast screening would save the state money by catching cancer early, reducing treatment costs. She said the proposal specifically covering state employees would have cost Kansas $75,000, but lawmakers killed it during budget negotiations last week.
Some legislators said they were concerned about the amendment raising health insurance costs, and some said it didn’t follow proper procedures through the legislative process.
Rep. William Sutton, a Republican whose district covers parts of Johnson and Douglas counties, said the amendment needed a financial analysis before being added to the budget.
“We’re putting the cart before the horse here; we’re not doing it according to the appropriate procedure at all,” Sutton said.
Rep. Troy Waymaster, the Republican chairman of the House Appropriations Committee, told the Kansas Reflector that the funding was cut because of the belief it should instead be part of contract negotiations on the state health insurance plan.
A bipartisan effort
Featherston was one of more than two dozen bipartisan sponsors on the breast cancer screening bill. The budget amendment focusing solely on state employees (for which she wouldn’t be eligible because she uses her husband’s employer-sponsored health insurance) was a last-ditch effort to save some version of it this session, she said.
Featherston said it’s frustrating to see the legislation fail because it has so much support.
“In a budget of over $25 billion, health care for women was seen as not important enough,” she said. “It’s really disappointing. It’s shameful.”
Guthrie, of the Komen Foundation, said they are disappointed in the Kansas Legislature for removing the amendment from the budget.
“State employees deserve better, and we hope this will be addressed during the veto session later this month,” Guthrie said in an emailed statement.
Featherston said she’ll keep working with Susan G. Komen and won’t stop pushing for this bill.
“Hopefully, we can just start doing the math and put aside special interest in politics and just get good policy across the line,” she said.
The Kansas News Service is a collaboration of KCUR, Kansas Public Radio, KMUW and High Plains Public Radio focused on health, the social determinants of health and their connection to public policy.
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