Boise — The Idaho House Health and Welfare Committee voted to send House Bill 134 to the House floor with a due pass recommendation after more than an hour of testimony from medical providers, patients and insurers about the financial and clinical barriers to supplemental breast imaging for high‑risk people.

The bill, presented by Representative John Healy of District 15 and Representative Brooke Green of District 18, would require private health plans in Idaho (excluding Medicaid and self‑insured, ERISA‑regulated plans) to cover supplemental breast cancer screening — including MRI, contrast‑enhanced mammography or targeted ultrasound — for people identified as at heightened risk because of genetic mutations, prior radiation, very dense breast tissue or relevant family history.

Supporters told the committee these services can detect cancers missed by standard mammography, reduce advanced‑stage diagnoses and lower long‑term treatment costs. "Breast cancer doesn't care about political parties and neither should we," Representative Brooke Green said during testimony. Green, who described her own recent diagnosis and dense breast tissue, urged the committee to remove financial barriers to early detection.

The bill's proponents included clinicians who described both clinical need and cost tradeoffs. Dr. Menon, a breast surgeon who trained at MD Anderson Cancer Center, said adjunct screening helps identify higher‑risk women earlier and averts more extensive and expensive treatment later. "An early stage breast cancer with a lumpectomy can be around $60,000 on average," Menon told the committee; "advanced stage cancer treatment ... can be 250, half a million dollars." Dr. Barbara White, a fellowship‑trained breast radiologist, told the committee adjunct screening raises detection from about 70–80% with mammography alone toward roughly 95% when combined with supplemental imaging for women with dense breasts.

Multiple survivors and patients recounted delays, high out‑of‑pocket bills and diagnoses that arrived after months of uncertainty. Tristan Taylor, a registered mammographic technologist and survivor, said she now requires an annual MRI in addition to a 3‑D mammogram and that her insurance does not cover the MRI until she meets her deductible. Amber Mosling, Cheryl Bloom, Misty Tolman and others described cases in which supplemental imaging either identified tumors early or where lack of coverage delayed diagnosis and led to more intensive treatment.

Committee members asked about fiscal impact and market response. Representative Kaler asked whether the state health plan's fiscal note — an estimated $300,000 to $600,000 — would ripple to the insurance exchange. Representative Green said she could not answer every actuarial question in the room but argued preventive screening reduces downstream costs; she added that her own mastectomy cost about $137,000. John Howell, a Boise resident, urged the committee to move the bill forward, telling members of a woman who died after a late diagnosis.

A representative of a self‑insured municipal trust, Amy Manning, told the committee her organization (IIIA) already covers 100% of screening and has seen a decline in cancer treatment costs and cases after implementing broader screening benefits. "From last year to this year, we have a 10 percent decrease in number of cancers and we have a 7.5 percent decrease in overall cost," Manning said, and reported a $2,000,000 drop in cancer treatment costs in recent claims data.

After public and expert testimony, Representative Redmond moved that the committee send House Bill 134 to the floor with a due pass recommendation. The motion carried; committee leadership recorded two nays and did not list both opposing members by name in the audible record.

Votes at a glance
House Bill 134 — Require private insurers (excluding Medicaid and self‑insured ERISA plans) to cover supplemental breast imaging for people at heightened risk
- Motion: Send to floor with a due pass recommendation (moved by Representative Redmond)
- Outcome: Motion carried; committee leadership recorded two nays (one named, Representative Kahler; the other not specified in the public record)

Why it matters
Idaho ranks low on routine breast screening and has relatively high out‑of‑pocket shares for diagnostic breast testing, according to testimony. Supporters say aligning coverage of adjunct imaging for clinically indicated high‑risk patients would reduce late‑stage cancer diagnoses, improve outcomes and may produce net savings by avoiding far costlier advanced treatments. Opponents signaled concern about mandates on private health plans and expanded coverage obligations.

What the bill says and limits
The bill targets private health insurance plans but excludes Medicaid and self‑insured plans regulated under federal ERISA law. It limits supplemental imaging coverage to persons clinically identified as higher risk because of genetic predisposition (including BRCA1/BRCA2), prior radiation, very dense breast tissue, pertinent family history or other medically determined high‑risk factors. Testimony emphasized that the coverage is intended to align necessary supplemental imaging with existing preventive mammography benefits, not to expand screening for the general population.

Next steps
With the committee's due pass recommendation, House Bill 134 will be scheduled for consideration on the House floor. The committee's fiscal estimates and insurer cost projections will likely be part of the floor debate; legislators and insurers signaled interest in evidence about long‑term cost offsets and implementation detail for plan administrators.

Sources: Testimony on record before the House Health and Welfare Committee during the February 17, 2025 hearing (presenters and excerpts cited below).