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Do Government Policies Impact Breast Reconstruction Rates?

| May 12, 2015 October 20, 2022 | |

do government policies impact breast reconstruction ratesEvery month, I look forward to receiving my copy of Plastic and Reconstructive Surgery, one of the main journals that publish plastic surgery-related research papers. This month, a paper out of the University of Michigan caught my attention. The researchers looked at how federal and state policy changes affected breast reconstruction after mastectomy.

One of the main policy changes considered is the Women’s Health and Cancer Rights Act of 1998. As we’ve described in the previous blog and on our resources page, this act, administered by the U.S. Departments of Labor and Health and Human Services, makes most insurance companies responsible for covering reconstruction after mastectomy. In addition to the initial reconstruction, it also includes coverage for all reconstruction stages, including procedures that might be needed to achieve a symmetrical result.

Will Insurance Cover Breast Reconstruction?

will insurance cover breast reconstruction

In our previous blog post, we discussed one of the main policy changes: the Women’s Health and Cancer Rights Act of 1998.

Read the article here

The Disparity in Patients

The University of Michigan study showed that after the act was passed in 1998, women were more likely to undergo breast reconstruction after mastectomy. Their study, which looked at a database summarizing hospital admissions in the state of New York, showed that by 2006, women were over twice as likely to have breast reconstruction.

However, the study shows that these increases are not equal for women of various ethnicities and races. For example, the increase in reconstruction for white women was 73%, which is much higher than the increases seen for Hispanic (38%) and African American (32%) women. These disparities suggest that more efforts are needed to communicate the reconstructive options available to women after mastectomy.

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What Government is Doing

Fortunately, some states have passed legislation to promote exactly this type of activity. For example, in Ohio, the Lizzie B. Byrd Act (Ohio House Bill 147) requires a surgeon performing a mastectomy in a hospital to guide the patient and provide referrals in a manner consistent with the standards of the National Accreditation Program for Breast Centers.

A recent proposal was made at the federal government level (S.1192 — 114th Congress) to pass a bill that would further promote education and awareness. Such legislation would likely have a widespread impact on the rates of breast reconstruction.

About the Author

Dr. Ergun Kocak, MD, is a board-certified plastic surgeon who specializes in plastic and reconstructive surgery of the breast using DIEP, SIEA GAP, TUG, PAP, and direct-to-implant, in Columbus and Cincinnati, OH.
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*Our blog entries are written in order to further educate our patients and raise awareness towards topics related to plastic surgery. Any solutions offered on this blog are intended to help possible patients develop educated decisions before undergoing a consultation with our doctors.

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