Oregon could become first state to eliminate surprise costs after cervical cancer screenings

Oregon lawmakers are moving closer to closing a gap in cervical cancer care that can leave patients with unexpected medical bills at one of the most stressful moments of their lives.

Senate Bill 1527 would eliminate out-of-pocket costs for diagnostic follow-up care after an abnormal cervical cancer screening.

If it becomes law, Oregon would be the first state in the nation to adopt such a policy. The new requirements would apply to insurance policies issued, renewed or extended after the law takes effect.

For many Oregonians, getting a routine Pap or HPV test is already covered by insurance. But when a test comes back abnormal, insurers often classify follow-up exams differently, shifting costs to patients even though doctors consider those procedures an essential part of the screening process.

That can leave patients facing large bills just as anxiety is peaking, supporters of the bill told lawmakers during a hearing as the Legislature opened its 35-day session this week. The bill passed out of the Senate Committee on Health Care on Wednesday and now heads to the Senate floor.

No insurance companies testified against the bill, and no written testimony was submitted in opposition as of Friday.

Under the proposal, most individual and group health insurance plans regulated by the state, as well as employer-sponsored insurers in the state, would be required to cover not only routine cervical cancer screenings but also the follow-up exams doctors order when those tests show concerning results — without charging patients anything out of pocket.

The bill would not require insurers to cover treatment for diagnosed cervical cancer. Instead, it focuses on early detection — the period between a routine screening and a confirmed diagnosis — when delays can dramatically affect outcomes.

In Oregon, 140 people were diagnosed with cervical cancer in 2024 and 50 died from the disease, according to the American Cancer Society. Nationally, 13,360 people were diagnosed with cervical cancer last year.

Rep. Anessa Hartman, D-Gladstone, told the committee that removing that financial uncertainty could help ensure patients complete the full screening process rather than postponing or skipping follow-up care.

Hartman shared her own experience undergoing four rounds of radiation therapy after being diagnosed with stage 3 cervical cancer last fall. She said that at age 37 she has been forced into early menopause as a result.

Hartman was able to access diagnostic testing and treatment promptly — an option many patients do not have. She has spoken in the past about a single mother of three in her district who learned she needed a $1,000 diagnostic exam and could not afford to cover it out of pocket.

Hartman told lawmakers that delayed diagnosis can lead to aggressive treatment with lifelong consequences.

“If diagnostic testing is being requested by qualified doctors, it should be covered, not left up to insurance companies to decide,” she said.

Jane Leo, Oregon government relations director for the American Cancer Society Cancer Action Network, told lawmakers that even insured patients can face steep bills for diagnostic procedures following abnormal screenings.

Those follow-up tests can cost between $700 and $1,200 or more, Leo said, and cost is a well-documented barrier to completing care.

Dr. Julia Tasset, an OB-GYN at Oregon Health and Science University and fellow of the American College of Obstetricians and Gynecologists, testified that cervical cancer is “almost entirely preventable” when screening and vaccination guidelines are followed. But she said gaps in insurance coverage cause patients to fall out of care at a critical moment.

Tasset said the financial burden of follow-up testing falls hardest on women of color and people with lower incomes — groups that already face longstanding barriers to health care. Earlier diagnosis, she said, allows for less invasive treatment, better outcomes and lower overall health care costs.

A 2022 national study by BioPath Solutions, a California-based health economics research firm, found that average health care costs four years after a cervical cancer diagnosis were significantly higher for patients diagnosed at later stages of cancer.

The bill is modeled after a 2023 Oregon law that bars insurance plans from charging out-of-pocket costs for medically necessary diagnostic or supplemental breast exams.

Lawmakers adopted amendments to extend the coverage requirement to public employee health plans offered through the Public Employees’ Benefit Board and the Oregon Educators Benefit Board. Some plans, like short-term health insurance policies, would be exempt.