On Monday, Novemnber 8th, I testified before the Joint Committee on Financial Services regarding two very important pieces of legislation: House Bill 4145 filed by Representative James Arciero and House Bill 1098 filed by Representative Colleen Garry. Both bills seek to tackle the rise in colorectal cancer diagnoses in the adult population of the Commonwealth. House bill 4145 would lower the age mandate for insurance covered colorectal cancer screenings and treatment to 30 years of age, drastically lower than the American Cancer Society recommended screening age of 45. This lower age mandate would address the belated diagnoses of this disease in our young adult population. Although House Bill 1098 has a higher age mandate, it goes one step further in that it creates a commission to study colorectal cancer in adults under 50 in the Commonwealth. This commission will be charged with ascertaining the prevalence of this disease in the under 50 population, as well as the unmet needs those individuals and their families, and providing recommendations for additional legislation, support programs, and necessary resources. As someone who lost a loved one to colon cancer at young age, it was an honor to offer my support for both of these bills.
My testimony was as follows:
Good morning Chair Crighton and Chair Murphy, members of the committee, thank you for the opportunity to speak on behalf of House Bill 4145, An Act relative to colon cancer screening filed by Representative Arciero.
Increasingly, young adults in their 20’s and 30’s are being belatedly diagnosed with colon cancer in the later stages of the disease. This is because colon cancer can largely be asymptomatic, and because doctors generally do not often consider colon cancer a threat in this age group
House bill 4145 would address the rising number of colon cancer deaths in our adult population in two ways. First, this act mandates the GIC, MassHealth, and private insurers provide, starting at 30 years of age, coverage for colorectal cancer screening as found medically necessary by the insured’s primary care physician, including:
- Flexible sigmoidoscopy every 5 years;
- (ii) Flexible sigmoidoscopy every 10 years plus FIT every year;
- (iii) KRAS, BRAF, PIK3CA Array as frequent as medically necessary;
- (iv) FIT-DNA every year or every 3 years, as medically necessary;
- (v) FIT every year;
- (vi) HSgFOBT every year;
- (vii) CT colonography every 5 years; and
- (viii) colonoscopy every 5 or 10 years.
Second, this act requires colorectal cancer screening services will not be subject to any co-payment, deductible, coinsurance, or other cost-sharing requirement.
Additionally, an insured individual will not be subject to any extra charge for any service associated with a procedure or test for colorectal cancer screening, which may include 1 or more of the following:
- removal of tissue or other matter;
- (ii) laboratory services;
- (iii) physician services;
- (iv) facility use, regardless of whether such facility is a hospital; and
- (v) anesthesia.
The American Cancer Society recommends regular colorectal cancer screenings at 45 years of age, but with the rise in diagnoses in our young adult population, 45 might not be early enough to detect this deadly disease. Lowering the age mandate for insured colorectal cancer coverage to 30 the best weapon the Commonwealth has to combat the rising number of colon cancer deaths.
Additionally, I want to use this time to draw your attention to House Bill 1098 An Act relative to colon cancer under the age of 50 years of age, prevalence, screening and insurance coverage and care in the Commonwealth aka Martha’s Bill, filed by Representative Garry.
This legislation addresses the same concerns and mandates the same coverage as House Bill 4145, although at the higher American Cancer Society recommended age of 45.
Where House Bill 1098 differs is the provision for a commission to study Colon Cancer under 50 in the Commonwealth.
This bill establishes a 13-member commission for the purpose of making an investigation and study of a mechanism to ascertain the prevalence of Colon Cancer under the age of 50 years old in Massachusetts, the unmet needs those individuals and their families, as well as providing recommendations for additional legislation, support programs, and necessary resources.
The Commission is required to report its findings to the House and Senate no later than December 21, 2022, and which will undoubtedly be invaluable as the Commonwealth continues to address this issue.
Chairs Crighton and Murphy, members of the committee, as someone who lost a loved one to colon cancer at a young age, it is my hope you recognize the merits of both pieces of legislation. I offer both H.1098 and H.4145 my strongest support, and most sincere recommendation for a favorable review.
Thank you for your consideration.