Bill Overview
Title: Increasing Access to Lung Cancer Screening Act
Description: This bill provides for coverage without prior authorization requirements of annual lung cancer screenings under Medicaid, Medicare, and private health insurance for individuals for whom screenings are recommended under U.S. Preventive Services Task Force guidelines. It also expands Medicaid coverage of counseling and pharmacotherapy for cessation of tobacco use to all individuals, rather than only pregnant women.
Sponsors: Rep. Higgins, Brian [D-NY-26]
Target Audience
Population: Individuals eligible for lung cancer screenings and/or tobacco cessation support
Estimated Size: 15000000
- The bill focuses on increasing access to lung cancer screenings, which primarily affects individuals at higher risk for lung cancer.
- Lung cancer screenings are recommended for older adults with a history of heavy smoking by the U.S. Preventive Services Task Force.
- The bill also extends cessation support services via Medicaid to all individuals, which could affect a broader population of smokers seeking to quit.
- Global adult population is approximately 5 billion, considering smoking prevalence and age criteria, a portion of this population will be eligible for both screenings and cessation support.
Reasoning
- The policy affects individuals eligible for lung cancer screenings, particularly older individuals with a history of heavy smoking.
- It also affects smokers in general due to expanded cessation support, impacting their health and wellbeing.
- Only those who meet the specific medical guidelines will experience direct impacts from expanded lung cancer screening access.
- Smokers or former smokers who were unable to afford or access cessation programs previously due to Medicaid restrictions are likely to see a significant impact.
- Not everyone eligible will engage with the policy changes (e.g., choosing not to get screened or not seeking cessation help).
- Many will feel immediate benefits from healthcare savings and peace of mind accessing necessary screenings.
- Budgetary constraints will require prioritization within the target population, limiting overall reach and the extent of additional support services provided.
Simulated Interviews
retired factory worker (Pennsylvania)
Age: 65 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 4/20
Statement of Opinion:
- I couldn't afford regular screenings before, but now I feel I can finally check my health properly without stressing about costs.
- Having free access to tobacco cessation support is something I wanted, and I might give it a try.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 9 | 3 |
office worker (California)
Age: 52 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- The policy is reassuring as it provides coverage for regular checks, ensuring I’m proactive about my health.
- The extra support for smokers is crucial and might help my brother who is still struggling to quit.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 9 | 5 |
retired engineer (Florida)
Age: 74 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- I’ve been diligent about health since quitting, and having this policy reduces the barriers I faced getting screenings.
- I think it's important for access to be broader, especially for those currently unable to quit.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 6 |
healthcare worker (New York)
Age: 45 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 2/20
Statement of Opinion:
- The ease of access for cessation programs is overdue and crucial for tackling my smoking habit.
- Screenings give me peace of mind concerning my future health if I struggle for longer.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 9 | 4 |
| Year 20 | 9 | 4 |
truck driver (Texas)
Age: 55 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 15.0 years
Commonness: 3/20
Statement of Opinion:
- The coverage of lung screenings without jumping through hoops is a life-changer.
- I’ve considered quitting but always struggled; any help would be welcomed.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 9 | 4 |
| Year 20 | 9 | 3 |
retired teacher (Ohio)
Age: 70 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- While I’m not directly impacted, the bill gives me hope for my children and grandchildren who smoke.
- Preventative measures like these can help my family in the long run.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 6 |
| Year 10 | 6 | 6 |
| Year 20 | 6 | 5 |
construction worker (Illinois)
Age: 58 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 3/20
Statement of Opinion:
- The policy is a safety net that reduces the risks I worry about due to my past smoking.
- Overall, it’s a welcome change for many of us who struggled to quit or get necessary medical checks.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 5 |
| Year 20 | 8 | 5 |
unemployed (Alabama)
Age: 60 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 20.0 years
Commonness: 2/20
Statement of Opinion:
- I’ve always found it difficult to quit tobacco and afford any sort of treatments.
- The policy seems like a lifeline toward better health without added financial pressure.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 3 |
| Year 5 | 8 | 3 |
| Year 10 | 9 | 3 |
| Year 20 | 9 | 2 |
teacher (Massachusetts)
Age: 63 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 4/20
Statement of Opinion:
- The lung cancer screening part is appealing since I’m always wary due to my occasional smoking.
- Access to cessation options might eventually sway me to finally quit altogether.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 5 |
restaurant manager (Washington)
Age: 48 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 3/20
Statement of Opinion:
- Finally having accessible programs built around cessation will give me new hope to try again.
- Knowing screenings are there for future security is a relief.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 4 |
| Year 20 | 8 | 4 |
Cost Estimates
Year 1: $2250000000 (Low: $1800000000, High: $2700000000)
Year 2: $2300000000 (Low: $1840000000, High: $2760000000)
Year 3: $2350000000 (Low: $1880000000, High: $2820000000)
Year 5: $2450000000 (Low: $1960000000, High: $2940000000)
Year 10: $2700000000 (Low: $2160000000, High: $3240000000)
Year 100: $4000000000 (Low: $3200000000, High: $4800000000)
Key Considerations
- The policy will likely increase short-term healthcare costs primarily through reimbursing additional lung cancer screenings and cessation services.
- Long-term benefits could include significant savings in healthcare expenses related to lung cancer treatments and other smoking-related illnesses.
- The bill intends to democratize access to healthcare services focusing on prevention, thereby potentially increasing the quality of life and reducing future financial burdens on healthcare systems.