Kansas insurance commissioner blends personal experience, advocacy on breast cancer bill
Vicki Schmidt, the Kansas insurance commissioner who was diagnosed with breast cancer in 2023, wants a Kansas Senate committee to pass a bill blocking insurance companies from requiring women to pay part of the cost of supplemental diagnostic testing for breast cancer. Proponents say reform will save lives, while critics say it raises business costs. (Photo by Sherman Smith/Kansas Reflector)
TOPEKA — Kansas Insurance Commissioner Vicki Schmidt supported a bill during her first term as a state senator that established a distinctive state license plate encouraging breast cancer awareness.
When that bill became law, Schmidt said, she put one of the plates on her car, in part, to honor the cancer struggle of then-Sen. Barbara Allen.
“Little did I know it would take on new meaning when my own breast cancer diagnosis appeared,” said Schmidt, referencing the discovery made in 2023. “I’m not going to lie. There were some tears. There was panic, fear and a lot of uncertainty. I’m living proof that early detection saves lives.”
Schmidt, who is seeking the Republican nomination for governor, recommended Monday the Senate Financial Institutions and Insurance Committee support Senate Bill 409. It would end the practice of Kansas insurance carriers requiring patients to pay part of the cost of follow-up, diagnostic examinations performed after a basic mammogram detected potential cancer.
Advocates of the bill said cost-sharing was an obstacle to early treatment because some patients couldn’t bear the hundreds or thousands of dollars required to get more testing. Physicians who specialize in cancer care said they had worked with cash-strapped patients who didn’t receive a confirmatory test until tumors spread and the cancer became more difficult and expensive to treat.
The Kansas Legislature mandated mammography coverage in 1988, but the cost-share for additional testing persisted in some policies. For the past two years, policies offered to Kansas government employees, including members of the Legislature, forbid cost-sharing for supplemental breast exams.
Nearly two-thirds of U.S. states, including Missouri, Oklahoma and Colorado, adopted laws forbidding cost-sharing on second-level confirmatory tests for breast cancer.
‘Simply put …’
No health care professional or organization testified in opposition. Lobbyists with the Kansas Chamber and Kansas Employers For Affordable Healthcare asked the committee to block the bill.
“Simply put, these examinations cost money,” said Andrew Wiens, executive director of KEAH. “Employers already face significant financial burdens in providing health care benefits to their employees, and adding more mandates will only exacerbate this issue.”
William Wilk, representing the Kansas Chamber, said the business coalition recognized the bill was introduced with good intent.
“We are in opposition to the principle only, with the acknowledgement that this practice takes place in many health plans,” he said.
Blue Cross and Blue Shield of Kansas, which is the state’s largest nonprofit health plan with 1 million clients in 103 counties, presented “neutral” testimony on the bill. Lobbyist Sarah Fertig said BCBS of Kansas ended cost-sharing for diagnostic or supplemental mammography in most of its health plans.
However, she said, BCBS of Kansas kept cost-sharing on secondary breast cancer exams in policies implemented before the 2010 enactment of the Affordable Care Act.
“There would be a financial impact to those plans as they would be newly required to absorb costs that have historically been paid by the patient,” Fertig said.
‘My cancer journey’
Deletion of cost-sharing contemplated under SB 409 passed the Kansas House in 2024, but was dropped during negotiations with the Senate.
Rep. Laura Williams, R-Lenexa, said inclusion of basic mammograms on insurance policies encouraged regular checkups. It didn’t make sense to insist on out-of-pocket payments by patients in need of more precise assessments, she said.
“We cannot ask women to be proactive about their health, only to punish them financially when they find something that needs investigation,” she said. “If we value the lives of Kansas women, we must value the entire process of saving them, not just the first step.”
Rep. Linda Featherston, D-Overland Park, said the bill was personal, because “throughout my cancer journey, I have been blessed to have the financial resources to have every test and treatment that was recommended by my doctor. I cannot help but think about women who do not have this privilege.”
Amy Patel, medical director of the Breast Care Center at Liberty Hospital, which is a part of the University of Kansas Health System, said a routine mammogram wasn’t definitive for women with dense breast tissue. She said women with dense tissue were four to six times more likely to develop breast cancer. Sophisticated testing was essential for those individuals and ought to be part of insurance policies, she said.
“I strongly support passage of this critical legislation that has the potential to save so many lives and reduce overall cancer care costs in Kansas due to early detection,” she said.