Earlier this month, senators approved, in a 61 to 39 vote, an amendment to the healthcare reform bill that would require health insurers to cover mammograms for women ages 40 to 49. The bill would guarantee coverage of mammograms and other preventive screenings for women without a copay.

US Preventive Services Task Force

The US Preventive Services Task Force (USPSTF) announced new mammogram guidelines last month. The USPSTF no longer recommends routine mammograms for women 40 to 49 years old. The most recent recommendations downgraded mammography in women under 50 to a "C" grade. The USPSTF also now recommend a mammogram for women 50 years old and older every two years instead of their prior recommendation of once every year for that age group.

The USPSTF recommendations are important because the healthcare reform bill that was passed by the House and the bill being considered by the Senate would require insurance companies to cover all medical services that receive a grade of "A" or "B" from the USPSTF. Insurance plans wouldn't be required to cover medical services that have a "C" grade.

Objections to USPSTF Recommendations

Several medical societies and expert groups, including the American Cancer Society, objected to the USPSTF's new recommendations. The USPSTF has been accused of playing politics in deciding to downgrade mammograms for women under 50.

Bipartisan Amendment

In response to the USPSTF's new recommendations, a bipartisan amendment, sponsored by Barbara Mikulski (D-MD) and Olympia Snowe (R-Maine), was introduced. The amendment would increase coverage and eliminate copays for more women's preventive services. The Mikulski amendment eliminates copays for regular well-women visits, breast exams and contraceptive services.

Vitter Amendment Passed

Senators actually approved an amendment to the Mikulski amendment, disregarding the USPSTF's recommendation that women under 50 shouldn't get routine mammograms. The amendment was offered by David Vitter (R-La) and it set aside the most recent USPSTF guidelines. The Vetter amendment to Mikulski's amendment would follow the USPSTF's 2002 guidelines, which gave a "B" grade to screening mammography in women ages 40 to 49. Under the Vitter amendment, health insurers would be required to cover the mammograms without a copay.

Progress of the Health Care Reform Package

The House of Representatives passed a health care bill last month, but the Senate must now do the same. After the Senate passes its own bill, the two chambers can move onto the next step and reconcile their two reform packages. Then no more amendments will be accepted and there will be a vote on the combined bill. The last step is for President Obama to sign the bill.

Questions for Your Attorney

  • Under the Vitter amendment, are mammograms for women ages 40 to 49 mandatory?
  • What are the US Preventive Services Task Force guidelines based upon?
  • Are mammograms for women ages 40 to 49 currently covered by all health insurers without a copay?

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