Hello all!
While my main priority is my health, in between appts, rest, and waiting for results, I am still actively pushing for change!
This morning I called Iowa’s governor’s office and spoke to someone who was very helpful. Citizens of Iowa cannot draft a bill on their own so she suggested my course of action right now would be to go through local legislation office.
Today I called and left a voicemail and then immediately following up with an email.
Below is a copy of the email. I plan to send it every other day until I hear back.
Hello,
I left you a voicemail this morning, albeit long, on hopes to gain support from you to draft a bill. This bill would remove the need for a patient to prove a genetic link as well as remove age as a determining factor for a patient to receive medically necessary cancer screenings.
I do have a petition out on Change.org, that like my voicemail, is lengthy. It’s difficult to not speak in great detail about an injustice that is happening when I’m so passionate about seeking a permanent resolution. The link to the petition is at the bottom of this email.
There are many factors that can determine someone’s risk to cancer, most of which are environmental. It is outdated, in my opinion, discriminatory and ageist to require two direct family members as having had cancer as well as being over age 45 in order to receive medically necessary cancer screenings.
My backstory is this:
In Nov I had symptoms of a rare form of breast cancer pop up. This type of cancer, Inflammatory Breast Carcinoma (IBC) does not present with a lump and is not familiar, meaning it does not run in families.
In December my insurance company at the time (A) approved my pre authorization for an MRI as recommended by my doctor.
Jan 1st my insurance changed (B). Company B denied my pre authorization citing that I was not high risk. High risk is defined as:
45+ years of age
Two or more direct family members as having breast and/or ovarian cancer.
Statistically speaking it is impossible for me to have two direct family members with breast cancer and/or ovarian cancer. I have a mother, father, two brothers, and three sons. My mother had her ovaries removed due to pre cancerous cells. Insurance B does not define pre cancerous as cancer so this is not able to meet the criteria. The likelihood of any other family member having ovarian cancer is 0% while the probability of breast cancer is less than 1% for any of the men, the chances drop even more if it’s required that TWO have it.
So with a less than 1% chance to prove a family connection to a form of cancer that does not run in families and no control over my age. I effectively cannot be considered for an MRI for 8 more years under these strict, outdated guidelines.
This is putting a LARGE number of Iowans at risk. Allowing insurance companies to have the final say is wrong. My doctor completed a peer-to-peer review with the insurance company and it was denied again. I appealed twice and both times it was denied citing the same reasons.
Expecting people to know the ins and outs of direct or even extended family members medical history is also outdated and wrong. Many people do not even know one (or both) of their biological parents. A child may grow up thinking a parent is their parent when they’re not. This requirement also removes any dysfunction or estrangement from the equation. I also believe that is unfair.
A Bill to propose that genetic connection and age CANNOT be the final determining factors for denial of what a doctor deems as a medically necessary cancer procedure(s), treatment(s), and/or screening(s) is needed immediately for Iowans.
I did complete some initial googling and research and it is widely accepted and leveraged by many states to have individual state laws that insurance companies must adhere to.
Please help me in removing this unnecessary, outdated, ageist, and unfair obstacle that insurance companies are getting away with.
Together we can save lives, reduce the cycle time in getting a diagnosis, and reduce the anxiety and stress that comes with having to battle (this is far beyond advocacy at this point) major insurance companies!
Petition:
https://chng.it/whqx9ysRh6
State insurance law evidence:
“There are several advantages to implementing reforms at the state level. State-level reforms can be tailored to work best for each state, depending on its size and demographics and the structure of its insurance markets. States also have considerable authority over the regulation of health insurance and the provision of health care within their borders.”