Bill Overview
Title: Reducing Hereditary Cancer Act of 2022
Description: 2022 This bill provides for Medicare coverage of germline mutation testing for individuals with a personal or family history of a hereditary cancer gene mutation or suspected history of hereditary cancer, as well as for associated coverage of risk-reducing surgeries and screenings.
Sponsors: Sen. Murkowski, Lisa [R-AK]
Target Audience
Population: Individuals with a personal or family history of hereditary cancer gene mutations
Estimated Size: 3000000
- The bill targets individuals with a personal history of hereditary cancer gene mutations.
- It also includes those with a family history of hereditary cancer gene mutations, expanding the affected group to relatives of known mutation carriers.
- The bill covers germline mutation testing, which identifies individuals with inherited mutations that predispose them to cancer.
- Risk-reducing surgeries and screenings will impact those already identified as carriers of such mutations.
- Hereditary cancer gene mutations can be found in genes like BRCA1, BRCA2, Lynch syndrome-related genes, which are relatively rare in the general population but significant in the context of carriers.
- People with suspected histories of hereditary cancer are also covered, which includes those at high risk due to their family history but not yet tested or confirmed.
Reasoning
- This bill impacts those with or at risk of hereditary cancer, particularly older adults due to the Medicare criterion.
- The budget constraints imply that not all eligible individuals will receive comprehensive coverage in the first year, but a significant portion over 10 years.
- Coverage includes testing, surgeries, and screenings, significantly enhancing early diagnosis and prevention strategies, likely improving wellbeing for many affected.
- The initial impact may be less visible for those without an immediate need for treatment, while others might see a drastic increase in wellbeing due to the removal of financial barriers.
- Greater family history depth and increased awareness could lead more people to seek testing and preventive treatment, but awareness campaigns might be needed to fully utilize the policy's benefits.
Simulated Interviews
Retired School Teacher (Miami, FL)
Age: 68 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 12/20
Statement of Opinion:
- The policy relieves financial stress for additional tests and preventive measures.
- I had to choose between my retirement savings and health procedures before.
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 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 8 | 5 |
Accountant (Des Moines, IA)
Age: 45 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 20.0 years
Commonness: 15/20
Statement of Opinion:
- I am relieved as I worried about early-onset cancer.
- Being able to have regular screenings means peace of mind.
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 | 6 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Librarian (Boston, MA)
Age: 62 | Gender: female
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- Getting tested and having coverage will lower my anxiety level.
- My doctor had advised me to get tested but I couldn't afford it.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 6 | 4 |
Construction Worker (Detroit, MI)
Age: 52 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 16/20
Statement of Opinion:
- It's good, but I never thought about getting tested before.
- More information would help people know what to do.
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 | 7 | 6 |
| Year 10 | 7 | 6 |
| Year 20 | 7 | 6 |
Tech Startup Founder (San Francisco, CA)
Age: 36 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 14/20
Statement of Opinion:
- More screenings will help keep my health on track.
- I see this as an important preventive step although I'm not immediately affected.
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 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
Retired Nurse (Atlanta, GA)
Age: 70 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 13/20
Statement of Opinion:
- I've always been worried about breast cancer; this gives me options.
- Testing and surgery are expensive without coverage.
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 | 9 | 6 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 5 |
Freelance Artist (Phoenix, AZ)
Age: 53 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 15.0 years
Commonness: 11/20
Statement of Opinion:
- This policy means I can afford regular screenings.
- Knowing the risk, it gives me confidence to act on it.
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 | 8 | 5 |
| Year 10 | 8 | 6 |
| Year 20 | 7 | 5 |
Professor (Chicago, IL)
Age: 60 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 20/20
Statement of Opinion:
- Good to see this covered—medically proactive.
- It's less relevant unless a family health history arises.
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 | 7 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 7 |
Chef (Seattle, WA)
Age: 41 | Gender: other
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 13/20
Statement of Opinion:
- I couldn't afford testing before; this is a lifeline.
- Reducing out-of-pocket costs is essential for me.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 5 |
| Year 20 | 7 | 5 |
Retired Engineer (Houston, TX)
Age: 65 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 14/20
Statement of Opinion:
- Finally, a way to assess genetic risks without high costs.
- I'd been putting off testing due to expenses.
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 | 6 |
| Year 10 | 8 | 7 |
| Year 20 | 7 | 6 |
Cost Estimates
Year 1: $1500000000 (Low: $1200000000, High: $1800000000)
Year 2: $1530000000 (Low: $1224000000, High: $1836000000)
Year 3: $1560600000 (Low: $1248480000, High: $1872720000)
Year 5: $1624848000 (Low: $1296979200, High: $1949817600)
Year 10: $1771561000 (Low: $1417248800, High: $2125873200)
Year 100: $5000000000 (Low: $4000000000, High: $6000000000)
Key Considerations
- The need to balance immediate testing costs with long-term savings from preventive care.
- Potential for Medicare budget reallocations to absorb initial expenditures.
- Measuring success through potential reduction in hereditary cancer cases and improved health outcomes.