Zotec Answers - A Healthcare Podcast

Why is the Find It Early Act still stalled, and is there a viable path forward for national 3D mammography coverage?

Episode Summary

In this episode of Zotec Answers, Jennifer Fox and Megan Applegarth discuss why access to 3D mammography, diagnostic breast imaging, and supplemental imaging can still depend on a patient’s zip code, health plan, breast density, and cost-sharing rules. They are joined by Mark Isenberg, Executive Vice President of Healthcare Advocacy at Zotec Partners, to examine the Find It Early Act, a bipartisan federal proposal that would expand coverage for breast cancer screening and follow-up imaging without patient cost sharing. Together, they explore state coverage gaps, ERISA limitations, dense breast tissue, insurer and employer concerns, early detection, and why national breast imaging coverage remains stalled in Congress despite broad support.

Episode Notes

October is Breast Cancer Awareness Month, and this episode takes a closer look at a critical healthcare access question: Should coverage for medically recommended breast imaging depend on where a patient lives or what type of insurance card they carry?

Jennifer Fox, Megan Applegarth, and Mark Isenberg break down the patchwork of state breast imaging coverage laws, the limits of state action for self-funded employer plans, and the potential impact of the Find It Early Act.

Key topics include:

• Why breast imaging coverage varies by state, plan type, and service classification
• The difference between screening, diagnostic, and supplemental breast imaging
• How dense breast tissue can make cancer harder to detect on a mammogram alone
• Why self-funded ERISA plans are often exempt from state insurance mandates
• What the Find It Early Act would change for patients, physicians, and clinicians
• How the bill could expand coverage for 2D mammography, 3D mammography, ultrasound, MRI, and other appropriate breast imaging
• Why eliminating deductibles, copays, and coinsurance may help reduce delays in follow-up care
• Why the bill has bipartisan support but remains stalled in Congress
• How committee jurisdiction, healthcare costs, and competing priorities affect the bill’s path forward
• Why early detection is central to improving outcomes and reducing long-term healthcare costs

The episode also encourages listeners to stay informed ahead of the 2026 midterm elections. For nonpartisan election resources, text ZPVOTE to 50457 to access the Zotec Election Center.