Idaho committee backs bill to require insurers to cover supplemental breast screening for high‑risk patients

The Idaho Senate Health and Welfare Committee voted to send House Bill 134 to the Senate floor with a do‑pass recommendation after hearing testimony urging private insurers to cover supplemental breast cancer screening for people at high risk.

Representatives Brooke Green (District 18) and Healy (District 15), sponsors of the bill, told the committee the measure would require private health plans (excluding Medicaid and certain self‑insured plans) to cover supplemental imaging — such as breast MRI, contrast‑enhanced mammography or whole‑breast ultrasound — for patients who meet clinical high‑risk criteria, including known BRCA1/2 mutations, prior chest radiation, or extremely dense breast tissue. Representative Green and Representative Healy said the coverage would apply only to patients who meet the bill’s specified qualifiers.

The bill’s sponsors and three clinicians told the committee that standard mammograms detect roughly 70–80% of breast cancers, while adjunct imaging can raise detection as high as about 95% for women with dense tissue or other risk factors. "Adjunct screening increases the detection to 95 percent," testified Dr. Barbara White, a fellowship‑trained breast radiologist. Dr. Aime Smith, a breast cancer surgeon who runs a high‑risk clinic, and Dr. Rhiannon Menon, a breast surgeon who treats patients statewide, described seeing patients who could not afford recommended supplemental imaging and later presented with more advanced disease.

Representative Green described her personal experience with two breast cancer diagnoses in 2024–2025 and said that out‑of‑pocket costs often prevent people from getting recommended enhanced imaging. "The same imaging that identified my breast cancer in December was not available to me in July," Green said. She and other witnesses told the committee that an MRI can cost several thousand dollars out of pocket for people subject to a deductible. Dr. Menon told the committee a diagnostic mammogram can cost about $800 out of pocket and an MRI about $3,000 out of pocket, figures she provided as examples of the financial barrier patients face when supplemental imaging is not treated as a covered preventive benefit.

Discussion at the hearing addressed cost and implementation. Representative Healy and Representative Green said the bill is intended to move this testing from the diagnostic/deductible category to a preventive category for eligible high‑risk patients. Representative Green said insurers were brought to the table during drafting and that payers are "neutral" on the bill. She also said a fiscal note submitted to the Legislature estimated state costs between roughly $300,000 and $600,000, but that regents ran alternative estimates for the state plan in the range of $36,000 to $72,000. The transcript includes other cost figures presented by sponsors and witnesses for treatment of advanced cancers (figures in testimony varied and, in some places, are reported inexactly in the record).

Physicians at the hearing emphasized eligibility criteria to limit overuse. Dr. Smith said the bill would apply to a focused group of patients with clinical indicators of high risk rather than to all women and men. She said that stratification reduces the chance of unnecessary follow‑up from false positives and helps target the benefit to those who most need it.

After public testimony and questions from committee members, Senator Lenny moved that the committee send House Bill 134 to the floor with a do‑pass recommendation; Senator Kaiser seconded the motion. The chair called for the ayes, and the committee voice‑voted the motion with no opposition recorded on the transcript.

Votes at a glance: House Bill 134 — motion to send to the Senate floor with a do‑pass recommendation. Moved by Senator Lenny; seconded by Senator Kaiser. Outcome: approved by voice vote (no roll‑call tally recorded in the committee transcript).

The committee hearing record includes multiple references to state statutory treatment of mammography (Section 41‑2,144 of Idaho Code was cited by a witness as an existing statute addressing mammography), and witnesses urged the committee to update coverage requirements to reflect newer imaging options. The bill’s sponsors emphasized bipartisan support among cosponsors and framed the change as targeted to patients who meet the bill’s clinical criteria.