May 27, 2013

Regarding Ruth Marcus’s May 22 op-ed column, “Our genes, ourselves”:

Myriad Genetics is far from the only party responsible for women lacking information that could save their lives. Insurance companies are de facto gatekeepers to BRCA testing, as their policies determine who will be tested. The inconsistency in policies is a critical women’s health issue.

My mother had breast cancer when she was 43, and her maternal grandmother also had breast cancer. When Mom sought BRCA testing, her insurance company denied coverage. She found out that she has a BRCA2 mutation only after she reached the age to qualify for Medicare, which did approve her testing request. Once we had her result, I was tested and learned that I inherited her mutation. But our access to this information was delayed by the fact that the test, at more than $3,000, was prohibitively expensive without the denied insurance coverage.

Under the Affordable Care Act, however, health plans will be required to provide coverage for medical services with an “A” or “B” rating from the U.S. Preventive Services Task Force. Current task force guidelines recommend “that women whose family history is associated with an increased risk for deleterious mutations in BRCA1 or BRCA2 genes be referred for genetic counseling and evaluation for BRCA testing.” This grade-B recommendation will be incorporated into medical plans under the Affordable Care Act.

The task force is in the process of revising these guidelines for BRCA testing, and the impact of these new guidelines could have a dramatic impact on women’s access to information.

Joi Morris, Santa Monica, Calif.

The writer serves on the board of the nonprofit FORCE: Facing Our Risk of Cancer Empowered.