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pace with medical advances, and patients are increasingly losing access to certain reconstructive procedures due to outdated federal law, lax state health insurance standards and private-payer policies that undervalue complex surgeries.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 10
ASPS continued its proactive work to strengthen and clarify the Advancing Women's Health Coverage Act (AWHCA). Building on last week's response to concerns identified by stakeholders, we engaged directly with key hereditary cancer advocacy groups to ensure the legislation continues to support safe, timely access to reconstruction for all patients - including those undergoing risk-reducing procedures.
On Thursday, Nov. 13, members of the ASPS advocacy team met with Facing Our Risk of Cancer Empowered (FORCE), a leading organization supporting individuals with hereditary cancer syndromes, including those with BRCA1 gene mutations. The conversation was both constructive and positive. FORCE expressed appreciation for ASPS elevating this issue quickly and for the collaboration underway to update the bill's language.
Prior to the meeting, we had previously shared refined language options with FORCE on behalf of aligned advocacy partners to ensure the bill which preserves access to reconstruction following prophylactic or risk-reducing surgery. FORCE's feedback, which helped guide the conversation, along with ongoing input from microsurgeons who routinely perform these complex procedures, is helping shape a solution that strengthens patient protections without unintended gaps.
ASPS values the partnership of groups like FORCE and will continue working closely with the broader community as revisions advance. Ensuring clarity in the legislation and safeguarding the rights of patients at high risk for hereditary cancers remains a key priority in advancing this legislation.
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