In May, actress Angelina Jolie revealed that she’d had a preventative double mastectomy. Such a procedure often comes after genetic testing which can be too expensive for uninsured or underinsured women. Now, under the Patient Protection and Affordable Care Act (ACA, or Obamacare), women will have access to preventative screenings and testing without the prohibitive price tag.
Women with certain genes at higher risk for breast cancer
Angelina Jolie decided to have the double mastectomy after learning she had a high-risk version of the BRCA1 gene. Women with a mutation in this gene or in the BRCA2 gene have much higher lifetime risks of developing certain cancers compared to women without these mutations: up to 85% higher risk for developing breast cancer and around 50-60% higher risk for developing ovarian cancer.
Genetic testing for mutations in the BRCA1 and BRCA2 genes can cost up to $4,000, an amount that many uninsured and underinsured women can’t pay. Women who have the testing and then want surgery can expect surgery bills up to $100,000, with out-of-pocket expenses in the thousands of dollars.
Although Jolie’s story was highly publicized, she was not the only celebrity to go under the knife. Christina Applegate, Kathy Bates, Sharon Osbourne, Wanda Sykes, and Giuliana Rancic all elected to have a double mastectomy, too.
ACA covers mammograms, genetic screening in some cases
On October 1st, open enrollment began for health insurance plans under the ACA, and under the new guidelines, many women will have more coverage for preventative care. As plans begin to go into effect January 2014, women can expect to see some changes in healthcare.
- Women with pre-existing conditions will be covered and cannot be denied insurance
- Out-of-pocket costs for many women will be reduced
- All women aged 40 and over are entitled to coverage for mammograms
- Women with a family history of breast and ovarian cancers are eligible for free testing for BRCA1 and BRCA2 mutations, and they are also eligible for free counseling
Though genetic testing is covered, women who find themselves at high risk and decide to have a double mastectomy are not necessarily covered under insurance under the ACA.
Reducing deaths from breast cancer
For women 40 and over, mammograms have shown to be effective at detecting breast cancer in the early stages and ultimately reducing mortality from breast cancer. Women in this age group with no known risk factors are advised to have mammograms every year or two. Women with high-risk BRCA1 and BRCA2 genes, and women with a family history of breast and ovarian cancer, are advised to have mammograms more often.
Women who had not had the insurance or the resources to cover the costs of a mammogram will soon be eligible for the lifesaving procedure. The CDC estimates that approximately 6.8 million low-income women will gain coverage under ACA, and that the number of annual mammograms could go up by half a million.
October is National Breast Cancer Awareness Month
To learn more about breast cancer, visit NBCAM.org.