Modernizing Breast Reconstruction Coverage
Ensuring Every Woman Has the Right to Comprehensive Breast Reconstruction
ASPS is leading a nationwide effort to modernize breast reconstruction coverage through the Advancing Women's Health Coverage Act and new or stronger state coverage laws. This legislation will ensure that every patient can access the full range of reconstructive options after treatment for breast cancer – whether advanced microsurgical or implant-based – regardless of where they live or what type of insurance they have.
Breast cancer, and the corresponding treatment, is physically and emotionally life-altering. Reconstruction allows women to restore their health, confidence and sense of wholeness after surgery. Today's options – including microsurgical procedures using a woman's own tissue – deliver some of the highest patient satisfaction and quality-of-life outcomes in modern medicine.
Unfortunately, access is uneven. Coverage laws written more than 25 years ago have not kept pace with medical advances, and patients are increasingly losing access to certain reconstructive procedures due to outdated federal law, lax state health insurance standards and private-payer policies that undervalue complex surgeries. Even where access is available, patients and doctors face obstacles from insurance companies in the form of denials, delays and demoralizing bureaucratic processes that are often broken by design.
ASPS is working at every level – federal, state and with private payers – to protect patient choice and modernize insurance coverage for reconstruction and complications following breast cancer treatment.
AWHCA Weekly Update for the Week of November 3
The Advancing Women's Health Coverage Act (AWHCA) was developed in partnership with dozens of ASPS Member Surgeons, including microsurgeons who regularly perform these complex breast reconstruction procedures. Last Friday, Oct. 31, the potential for misinterpretations of the new language to impact access to reconstruction following risk-reducing or prophylactic procedures was identified and elevated to our advocacy team. Once notified, we immediately began working to address this concern, including pausing delivery of a letter of support for the AWHCA from more than 40 medical and patient advocacy organizations. We did this because we recognized the importance of correcting any bill language that could potentially be misconstrued to negatively impact coverage.
Efforts to develop updated language are underway, with ASPS meeting with key hereditary cancer stakeholder groups this past Monday, Nov. 3, and sharing corrective options with those groups on Tuesday, Nov. 4. ASPS remains deeply committed to the mission of continued patient support and to strengthening access and protections that align with today’s standards of care.
ASPS is pursuing a coordinated nationwide approach to protect patient choice and modernize coverage laws. This includes federal legislation through the Advancing Women's Health Coverage Act, which updates federal protections to reflect today's medical standards, and state-level reforms that ensure fair payment, adequate networks and coverage for the full spectrum of reconstructive and restorative options after breast cancer.
This initiative is bigger than ASPS. Patients, providers and advocacy organizations are coming together to ensure women everywhere have access to comprehensive reconstruction and restorative care following breast cancer. To join this movement, you can:
- Share your story – help show lawmakers why WHCRA needs to be modernized
- Learn about state-specific coverage laws and how they impact access to care
- Endorse the legislation – if you or your organization would like to formally endorse the Advancing Women's Health Coverage Act, please email advocacy@plasticsurgery.org