FLORIDA — A powerful development has emerged from our ongoing investigation into health insurance companies denying breast cancer patients coverage for critical care. On Friday, Republican U.S. Congresswoman Kat Cammack of Ocala, FL, and Debby Dingell, a Democrat from Michigan, filed bipartisan new legislation to update protections for breast cancer patients.
WATCH: New federal legislation aims to close insurance loopholes denying breast cancer patients coverage
Known as the Advancing Women’s Health Coverage Act, to modernize the Women’s Health and Cancer Rights Act of 1998 (WHCRA), the legislation follows months of our exclusive reporting, which revealed how insurers were systematically denying patients coverage for reconstruction surgeries related to their breast cancer.
If approved, this law will be named after Rachel Roth McKnight, a young Tampa Bay mother whose personal breast cancer journey helped inspire these changes. We’ve followed Rachel’s cancer and insurance battle since February.
"It would be a huge relief for me, personally, but also just knowing that other people don't have to go through this is I can't even put it into words," Roth-McKnight said about what the legislation means to her.
"I feel like patients finally have a voice again," said Dr. Alicia Billington, a reconstructive plastic surgeon in St. Pete who has joined a growing number of doctors taking their frustrations about patient insurance denials to social media.
Billington is a staunch advocate for updating the Women’s Health & Cancer Rights Act (WHCRA) with other members of the American Association of Plastic Surgeons.
WHCRA was implemented by Congress in 1998 to protect insurance coverage for breast cancer patients who undergo reconstructive surgeries after their mastectomies.
But advocates say the nearly three-decade-old law has become outdated, paving the way for U.S. health insurance companies to find loopholes to justify claim denials.
In February, Investigative Reporter Katie LaGrone and photographers Matthew Apthorp shared the stories of real women battling their disease while simultaneously fighting their insurer to cover costs, often for reconstruction after mastectomies.
"I was denied my reconstruction," one patient told us.
"I was denied the type of mesh that my doctor recommended," another shared.
"You get refused, refused and refused, you know, and you start thinking, Am I going to get through it?" another patient explained.
"All of us have been denied life-saving measures," Roth-McKnight told us during our group interview with patients.
Roth-McKnight is a young mother of two diagnosed with breast cancer. She also tested positive for the BRCA gene, making her more susceptible to other cancers. Her list of denials from her insurance company was lengthy. She said she was initially denied her reconstruction surgery. In fact, Dr. Billington’s office learned she was denied coverage while Dr. Billington was performing her reconstructive surgery. Eventually, the surgery got covered by her insurer, but not without a fight, said McKnight.
"I feel like this isn't just about getting better and fighting the cancer, I'm also fighting them to cover my treatment,” she told us last month when we revisited her. “Almost every major thing since then has been either a deny or a delay," Roth-McKnight said.
If approved, the proposed new legislation to update WHCRA would require insurance companies to cover any type of breast cancer-related reconstruction and future options as science, technology, and medicine continue to evolve.
"This is legislation that has never been filed before," Billington said.
For doctors and patients, if approved, it will be life-changing.
"All of the frustration and all of the horrible things that they [patients] have gone through, it finally has meaning, and they are going to finally feel humanized again that the people want to help them and are on their side," Billington said.
The legislation was spearheaded by the American Society of Plastic Surgeons (ASPS). Billington, a member of the organization, traveled to Washington D.C. this summer with other members to meet with lawmakers, including U.S. Representative Kat Cammack of Florida, who decided to sponsor the legislation with Representative Dingell.The bill still needs a sponsor in the U.S. Senate.
"Women should be fighting cancer rather than insurance companies. Every woman battling breast cancer deserves access to the best care modern medicine can offer—not limits based on outdated insurance codes & bureaucratic red tape,” Cammack said.
The American Society of Plastic Surgeons believes the legislation, if approved, will be a game-changer for breast cancer patients.
“This important legislation will improve patient access to all types of breast and chest wall reconstruction. ASPS developed and fought for its introduction because ASPS Member Surgeons have an unrelenting commitment to every patient and their right to complete reconstructive care. In no place is this right more clear and more impactful, than with post-cancer care."
A spokesperson from the AHIP, a trade organization for the health insurance industry, said they could support the legislation.
“Health plans work to connect patients with safe, clinically appropriate care and welcome opportunities to work with policymakers and stakeholders to address gaps in care adequately and precisely while promoting affordability for consumers and sustainability within our health care system,” the spokesperson sated.
As for the informal name, ‘Rachel’s Law,’ Dr. Billington said it was a no-brainer.
"When we were thinking about the name, I just thought Rachel is the first person that I thought of, because she's the one that started all this," Dr. Billington said. When asked about having the law named after her, McKnight became overwhelmed with emotion.
"I don't really feel like it's something I deserve. It's an honor,” she said. “I take it as a sign that I need to continue to use the position that I have to advocate for everyone," she said.
This story was reported on-air by a journalist and has been converted to this platform with the assistance of AI. Our editorial team verifies all reporting on all platforms for fairness and accuracy.
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Katie LaGrone focuses on making sure Florida’s laws actually work and her investigations have gotten results. If you know of a policy or law that’s not working how it’s intended, send Katie a message below.
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