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Hearing Of The Subcommittee On Health Of The House Committee On Energy And Commerce - Breast Cancer Legislation: H.R. 995, H.R. 1691, H.R. 1740, And H.R. 2279


Location: Washington, DC

"Good morning. Today the Subcommittee is meeting to review four bills relating to
breast cancer: HR 995, the Mammogram and MRI Availability Act of 2009 (Nadler); HR 1691,
the Breast Cancer Patient Protection Act of 2009 (DeLauro); HR 1740, the Breast Cancer
Education and Awareness Requires Learning Young Act of 2009 (Wasserman Schultz); and HR
2279, the Eliminating Disparities in Breast Cancer Treatment Act of 2009 (Castor). I would like
to thank all of the sponsors of these bills for their hard work on raising awareness about these
very important issues.
"Aside from non-melanoma skin cancer, breast cancer is the most commonly diagnosed
cancer in women. The NIH estimates that over 190,000 new cases of breast cancer will be
diagnosed in women in 2009. And though we have seen breast cancer death rates decline since
1990, still approximately 40,000 women will succumb to the disease this year.
"This is why the work of advocacy groups and the key sponsors of the bills today, is so
crucially important. We have made great strides in detecting and treating breast cancer but there
is still much more to be done, and much more to learn.
"While all of these bills address concerns related to breast cancer, they all focus on
different aspects of the disease from screening and early detection to treatment and quality
improvement. And they all raise very important issues with respect to how breast cancer
patients, or any other patients for that matter, are being treated in the medical environment we
live in today. Not every American has access to good preventive services; not every American
has the good fortune to have an insurance plan that covers the medical care they need.
"That's why we are hard at work trying to pass health reform legislation that will
improve access to quality and affordable health care for every American. If enacted, health
reform legislation will dramatically improve our efforts in the battle against breast cancer.

"Particularly important are the insurance reforms. In drafting America's Affordable
Health Choices Act, we took the same tact as Ms. DeLauro did in taking decision making
authority out of the hands of health insurers and putting it back in the hands of patients and their
doctors, where it belongs.
"In addition, the subsidies offered in the Exchange and expansion of the Medicaid
program to cover childless adults will mean that many low and middle income women who
might not have access to health insurance today will be covered in the future thanks to health
reform. That means they will be able to access a doctor and receive treatment when they need it.
"A key component to winning the battle against breast cancer is effective and appropriate
screening, which both Ms. Wasserman Schultz' and Mr. Nadler's bills seek to address. Early
detection of breast cancer has long been acknowledged as an effective way to improve outcomes.
In fact, studies have shown that the 5-year survival rate in women who have received timely
treatment due to early detection is at 98%. This is why the US Preventive Services Taskforce
has recommended that all women over the age of 40 have a mammography screening every one
or two years.
"I agree with my colleagues. Early detection and prevention is key to survival. That's
why in health reform we bolster the very important work that the US Preventative Services Task
Force does by providing increased funding so that they can analyze more studies and make more
prevention recommendations. The evidence-based recommendations that receive the highest
ratings from the task force, such as mammography screenings, will be covered by all insurance
carriers participating in the Health Insurance Exchange and by Medicaid. And while Medicare
already covers these services, under health reform, beneficiaries would no longer face cost-
sharing requirements to receive them.
"In addition, we must also improve the quality of care that is provided in this country as
Ms. Castor is seeking to do with her bill. Tens of thousands of Americans die due to preventable
medical errors every year. Billions of dollars are wasted on low quality care. We as a nation
must do better.
"Improving quality is a concept we picked up in Health Reform as well. We require the
Secretary to establish national priorities for quality improvement and we also create a Center for
Quality improvement. The center will develop and encourage the use of best practices for
quality assurance and will provide implementation grants to those who are already doing
innovative work to improve the quality of care. Using breast cancer as an example, we can and
must do better to ensure that all Americans receive the highest quality care and that we collect
data that will help us continuously improve as more information becomes known about the
medical system and specific diseases.
"I would like to thank all of our witnesses for being here today, I look forward to your
testimony. I now recognize our Ranking Member, Mr. Deal for five minutes for the purpose of
making an openings statement."

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