Bill Overview
Title: Access to Scalp Cooling Therapy Act of 2022
Description: This bill requires health insurance plans (including public health insurance programs such as Medicare, Medicaid, and the Children's Health Insurance Program) to provide coverage for therapeutic devices used to cool the scalp of an individual to prevent or reduce hair loss during chemotherapy (e.g., cooling caps, hypothermia caps, and cold caps).
Sponsors: Rep. DeLauro, Rosa L. [D-CT-3]
Target Audience
Population: People undergoing chemotherapy
Estimated Size: 1500000
- The legislation pertains to individuals undergoing chemotherapy, which is a common treatment for cancer.
- Globally, millions of people are affected by cancer and receive chemotherapy treatment each year.
- Scalp cooling therapies are specifically aimed at reducing chemotherapy-induced alopecia, which is a common side effect of chemotherapy.
- Most individuals undergoing chemotherapy value these therapies for their potential to help with retaining hair, which is significant for mental and emotional well-being.
Reasoning
- The Access to Scalp Cooling Therapy Act of 2022 intends to support individuals undergoing chemotherapy by helping them avoid alopecia, a distressing side effect.
- Around 1.8 million new cancer cases are diagnosed annually in the U.S., with many undergoing chemotherapy, necessitating a large policy reach.
- The policy budget of $3,750,000,000 in year 1 needs to serve as many as possible, and efficiencies in policy implementation will be key to maximizing positive impact for the targeted 1.5 million Americans.
- Scalp cooling therapy is significant for preserving mental health and overall well-being which can differ based on demographics like income, age, and health coverage.
- In our simulation, not every cancer patient might choose to use the therapy; hence, impact varies based on personal choice and clinical advice. It also affects different demographics unequally due to varying impact magnitude and access prior to policy.
Simulated Interviews
Teacher (New York, NY)
Age: 55 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 6/20
Statement of Opinion:
- I am happy that this therapy is covered now. Hair loss is a big issue for me mentally.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 3 |
Software Engineer (Austin, TX)
Age: 38 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 2.0 years
Commonness: 8/20
Statement of Opinion:
- I'm relieved insurance will now cover something that supports my mental health during treatment.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 5 |
| Year 10 | 5 | 4 |
| Year 20 | 5 | 4 |
Retired (Chicago, IL)
Age: 70 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- Thankful that Medicare covers this now. I was worried about hair loss.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 3 |
Nurse (Denver, CO)
Age: 45 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 0.0 years
Commonness: 5/20
Statement of Opinion:
- If I needed chemo, I'd use it. Glad it’s covered but it doesn’t apply to my choice.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 5 |
| Year 3 | 5 | 5 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 5 | 5 |
Construction Worker (Miami, FL)
Age: 60 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 3.0 years
Commonness: 4/20
Statement of Opinion:
- I'm not sure this will help me, but if it does, it'll be one less worry.
- My hair isn't my main concern, but my wife's support influenced my relief that it's covered.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 4 | 4 |
| Year 2 | 5 | 4 |
| Year 3 | 5 | 4 |
| Year 5 | 4 | 3 |
| Year 10 | 3 | 2 |
| Year 20 | 3 | 2 |
Artist (San Francisco, CA)
Age: 33 | Gender: other
Wellbeing Before Policy: 5
Duration of Impact: 4.0 years
Commonness: 5/20
Statement of Opinion:
- It's a relief to maintain some control over my appearance during this trying time.
- Having this option covered supports my well-being significantly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 6 | 4 |
| Year 10 | 5 | 3 |
| Year 20 | 4 | 3 |
Graduate Student (Seattle, WA)
Age: 28 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 4.0 years
Commonness: 6/20
Statement of Opinion:
- I'm grateful that these new caps are accessible.
- This coverage eases a significant emotional burden.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 2 |
| Year 20 | 5 | 2 |
Intern (Los Angeles, CA)
Age: 22 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 3/20
Statement of Opinion:
- I think it'll help ease some parts of my treatment. Happy we won't pay more.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 3 |
Small Business Owner (Phoenix, AZ)
Age: 47 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 4/20
Statement of Opinion:
- As an entrepreneur, there are many costs; this coverage eases one financial stress.
- It's great to have support for something affecting well-being significantly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 8 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 2 |
Retired Engineer (Boston, MA)
Age: 62 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 0.0 years
Commonness: 5/20
Statement of Opinion:
- I'm glad there's progress in improving cancer care options; however, my insurance already covers the essentials for me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 6 | 6 |
| Year 5 | 5 | 5 |
| Year 10 | 5 | 5 |
| Year 20 | 4 | 4 |
Cost Estimates
Year 1: $3750000000 (Low: $3000000000, High: $4500000000)
Year 2: $3806250000 (Low: $3045000000, High: $4567500000)
Year 3: $3863475000 (Low: $3090675000, High: $4636515000)
Year 5: $3978479250 (Low: $3189557250, High: $4777401250)
Year 10: $4210305383 (Low: $3379643985, High: $5064375610)
Year 100: $9227448223 (Low: $7400245007, High: $11064651439)
Key Considerations
- The cost of devices varies significantly, and coverage mandates could drive prices upward if demand increases faster than supply.
- Scalp cooling is not universally effective or recommended for all cancer treatment regimens, potentially affecting uptake rates.
- Public perception and awareness of scalp cooling could alter the number of individuals seeking treatment.