The Diagnostic Mammogram Act: Advancing Health Equity Through Improved Breast Cancer Screening
Imagine going to the doctor’s office, hoping for answers, and hearing your doctor say “we’ll need to take a closer look”— only to find out that you can’t afford the next test. This is often the harsh reality for many women, especially Black, Latina, and Asian women, who are more likely to have dense breast tissue—making their breast cancer harder to detect and requiring more advanced scans. Breast cancer has always been one of the most common cancers worldwide, and it’s well established that early detection can save lives. Yet, many women are still diagnosed too late. This is because for those with dense breast tissue, the necessary screening that they need has long come with a high price tag. A price tag that too many simply cannot afford.
The Diagnostic Mammogram Act, recently passed in Illinois, addresses this critical problem. This act is more than just a health insurance rule. It’s a big step forward to close a dangerous gap in cancer care to give all women a fairer shot at survival.
What Is the Diagnostic Mammogram Act?
The Diagnostic Mammogram Act, co-sponsored by Representative Nabeela Syed, was signed into law by Governor J.B. Pritzker on August 26, 2019, and took effect on January 1, 2020. This law requires insurance companies in Illinois to cover the cost of advanced breast imaging without extra out-of-pocket costs, helping ensure timely detection and care. Before this law, many patients had to pay hundreds or even thousands of dollars out of pocket for these tests, creating a financial barrier that caused delayed diagnosis and treatment. For women of color, who are more likely to have dense breast tissue, which requires these advanced scans for proper detection, the lack of coverage resulted in significant economic hardships and unequal access to healthcare. By mandating that insurance companies provide coverage for follow-up screenings, this act removes obstacles to early detection, potentially saving millions of lives in the future.
How Has Breast Cancer Screening Left Some Women Behind?
For many women, especially with dense breast tissue, the standard mammogram simply isn’t enough. Dense tissue isn’t a medical condition and it is common for many people. But it poses a serious diagnostic challenge: both dense breast tissue and tumors appear white on the standard mammogram, making it significantly harder to spot cancer early, when it’s most treatable.
This challenge doesn’t impact all women equally. In fact, A key study from the Breast Cancer Surveillance Consortium (BCSC) found that Breast density varies significantly by race:
・Asian woman are 19% more likely than average to have dense breasts
・Black woman are 8% more likely
・Latina woman have an average rate
・White woman are 4% less likely
These disparities mean that women of color are disproportionately affected by the limitations of standard screening. Detecting cancer in their dense breast tissue often requires more advanced imaging like ultrasounds or MRIs, which are costly and usually not fully covered by insurance. Therefore, access to these tools isn’t always guaranteed—it often comes down to whether you can afford it or not.
A Long History of Inequality
These disparities in breast cancer detection and outcomes aren’t new. In fact, they are rooted in a much longer and more troubling history. For decades, women of color have faced limited access to quality screening and care. These patterns tie back to segregated hospitals, underfunded clinics and discriminatory policies that have created a persistent health care divide. Medical research and clinical trials historically excluded non-white women, leading to misaligned treatments. Social stigma, language barriers, and medical mistrust have also contributed to delayed diagnoses and poorer outcomes.
Today, these inequalities still show up severely. According to the research published by the American Cancer Society, Black women have a 4% lower incidence rate of breast cancer than white women but a 40% higher breast cancer death rate, caused by women receiving delayed treatment.
Looking Ahead
The diagnostic Mammogram Act is more than an insurance mandate, it’s a correction in a broken system which we had created before. When critical follow up scans are free at the point of care, people can make the healthiest decision without worrying about of the cost. Early detection works when it’s accessible. The diagnostic Mammogram Act provides that coverage matters and that no one should be left behind because their biology didn’t fit the insurance script. Though the law is still new, it has the potential to reduce late stage diagnosis and improve survival rates, giving all people no matter their race or income, the fair shot at survival. As more states consider similar mandates, Illinois Law could become a model for nationwide change.