Paying out of pocket for breast cancer screenings

Summary

Marketplace Morning Report Summary Episode: Paying out of Pocket for Breast Cancer Screenings
Release Date: June 27, 2025

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1. Introduction

David Brancaccio opens the episode from Los Angeles, highlighting the juxtaposition between record-high stock markets and business leaders' frustrations over policy uncertainties. The episode primarily delves into the financial challenges surrounding breast cancer screenings, particularly for women with dense breast tissue.

2. Stock Market Insights

• Record Highs Amid Uncertainty:
  Despite ongoing policy uncertainties causing business leaders to delay decisions, major stock indices like the S&P and NASDAQ reached all-time highs.

  "The stock market is anticipating profits just now," says Monica Nicholsburg (01:37).

• China Framework Announcement:
  Traders are optimistic following the official signing of the China framework, signaling potential trade deals with ten additional countries.

  "It's official," Monica notes, emphasizing that this excitement might stem from previously anticipated news (01:37).

• Federal Reserve's Inflation Indicator:
  The personal consumption expenditures index showed a slight increase but remained within acceptable limits for the Federal Reserve's stringent policies.

  "That's plenty good enough to meet their strict demands," Monica explains (02:55).

3. Global Oil Market Stability

• Strait of Hormuz Tensions:
  Recent conflicts between Iran and Israel raised fears of a blockade in the Strait of Hormuz, a critical oil transit route. However, experts like Ben Cahill assert that Iran is unlikely to close the strait due to the adverse economic impact.

  "Revenues... are not in the interest of the Iranian state," Cahill states (05:38).

• Impact on Shipping and Trade:
  Dubai's status as a global trade hub remained resilient, though container shipping rates surged by 55% during the conflict. Roshman Manoli highlights the temporary nature of these disruptions, with prices expected to stabilize over time (06:45).

4. Breast Cancer Screenings: Financial Barriers

• Importance of Early Detection:
  Annual mammograms are essential for women aged 40 and above, but their efficacy is limited for those with dense breast tissue, necessitating additional screenings like ultrasounds.

• Insurance Coverage Challenges:
  Approximately half of the women undergoing mammograms have dense breast tissue, requiring extra screening that isn't always covered by insurance. Dr. Julie Gershon emphasizes the necessity of ultrasounds but notes frequent disputes with insurers over coverage (09:18).

• Out-of-Pocket Costs:
  Patients may face significant out-of-pocket expenses, with ultrasounds costing over $300 and potential MRIs reaching up to $1,000 if further testing is needed. Jenny Hetzel Silbert shares her three-year battle with insurance companies before being diagnosed with cancer (09:40).

5. Legislative and Advocacy Efforts

• State-Level Reforms:
  Rhode Island successfully passed a bill in 2023 mandating insurance coverage for follow-up screenings, joining 34 other states with similar laws.

• Bipartisan Congressional Bills:
  Washington is witnessing a push for several bipartisan bills aimed at reducing out-of-pocket costs for breast cancer screenings, signaling potential nationwide reforms.

• Advocacy Organizations:
  Jessica Baladad of "Feel for Your Life" urges patients to understand their state-specific insurance requirements and stay informed about their rights to navigate high screening costs effectively (10:34).

6. Future Prospects

• National Conversations:
  The issue of insurance coverage for breast cancer screenings is gaining traction in national discussions, with potential policies that could alleviate financial burdens for patients nationwide.

• Role of Awareness and Education:
  Increased awareness about the importance of additional screenings for dense breast tissue and patient education on insurance rights are crucial steps toward ensuring better healthcare outcomes.

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This summary encapsulates the key discussions and insights from the "Marketplace Morning Report" episode on June 27, 2025. For a comprehensive understanding, listening to the full episode is recommended.

Transcript

[Advertiser]

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[Joshua McNichols]

Here in Seattle, we're building the technologies.

[David Brancaccio]

Of the future, from AI to clean energy.

[Monica Nicholsburg]

But we're also dealing with some of.

[Joshua McNichols]

Today'S biggest challenges like the housing crisis and the skyrocketing cost of living. We're here to break it all down for you. I'm Joshua McNichols.

[Monica Nicholsburg]

And I'm Monica Nicholsburg.

[Joshua McNichols]

Join us on Booming, a weekly podcast from KUOW about the economic forces shaping our lives here in the Pacific Northwest. Listen on the KUOW app or wherever you get your podcasts.

[David Brancaccio]

A record high stock market. I'm David Brancaccio in Los Angeles. First, business leaders complain of all the policy uncertainty forcing them to put decisions on hold. But the stock market is anticipating profits just now. The S and P and the NASDAQ indexes started trading at all time highs. On Friday, we turned to Christopher Lowe, chief economist at FHN Financial in New York. Hey, Chris.

[Monica Nicholsburg]

Good morning, David.

[David Brancaccio]

First of all, stock market, some of the index's new all time highs despite all this uncertainty. What do you make of this?

[Monica Nicholsburg]

Well, according to traders who've talked to the press, they're excited because the China framework was announced yesterday. Now bear in mind, this is the same China framework that was announced weeks ago, the one they negotiated in London. What happened yesterday was all the necessary bureaucrats in both countries finally signed off on it. So it's official. I think it's a bit of excitement maybe over old news. Although Howard Lutnick, the commerce secretary, did add that he thinks we're very close to deals with 10 other countries.

[David Brancaccio]

Yeah, that's interesting. You also had the White House chief economic adviser Steven Mirren telling Yahoo. Finance that he expects countries will get extensions pass the July 9 tariff deadline if those countries have been negotiating trade with the US in earnest.

[Monica Nicholsburg]

You know, honestly, maybe that's really the most important thing because it means, you know, that that deadline clock is ticking, the pause is about to end. And it means the average tariff rate is not going to kick all the way back up to where it was on April 2nd. And that's really important.

[David Brancaccio]

And briefly, we got the Fed's preferred inflation indicator today. Personal consumption expenditures. Terrible name. It was up just a sliver more than expected, but it didn't look out of whack.

[Monica Nicholsburg]

No, it's not bad. And remember too, the Fed policy is positioned for the worst case scenario, not their expected scenario. So a little bit higher than expected. That's plenty good enough to meet their strict demands.

[David Brancaccio]

Christopher Lowe, Chief Economist, FHN Financial thank you.

[Monica Nicholsburg]

Thank you, David.

[Advertiser]

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[David Brancaccio]

8, 10% now, still under $66 a barrel. One way to know it's business as usual, that kind of day. Through the narrow stretch of water between Oman and Iran, the Strait of Hormuz. It's a low oil price that suggests the Israel Iran cease fire is holding for now. Our colleague at our partner the BBC, Samir Hashmi, reports from Dubai.

[Sameer Hashmi]

For nearly two weeks, Iran and Israel were locked in their most intense conflict in decades. And for a few hours, it felt like the Gulf was on the brink. One of the biggest fears, that Iran might block the Strait of Hormuz, one of the world's most important shipping routes and its most vital oil transit choke point, with nearly 20% of the world's oil passing through it. Ben Cahill is an energy expert at the center for Strategic and International Studies. He says Iran closing the Strait was never a likely scenario.

[Joshua McNichols]

The full closure of the Strait would cut off Iran's critical source of export.

[Sameer Hashmi]

Revenues, foreign currency revenues. And that's definitely not in the interest of the Iranian state or the oil sector.

[Joshua McNichols]

So that would be a major reason.

[Sameer Hashmi]

Why Iran would not decide to go for a full scale closure of the strait. And no matter what happens in the months to come, I mean, Iran will be highly dependent on oil revenues. But it wasn't just oil that was affected. I'm standing right now at Dubai Creek, the heart of old Dubai's trading routes. But now this place has become more symbolic than strategic. But just a few kilometers away from here sits Jabal Ali, the largest port in the Middle east and one of the busiest in the world. Over the last few decades, Dubai has emerged as a major global trade hub, connecting Asia, Africa and Europe. But the recent Israel, Iran conflict threatened to disrupt that rhythm. Average container shipping rates jumped by 55%. Roshman Manoli is the vice president of freight forwarding at Consolidated Shipping Services, one of Dubai's largest freight companies. At the moment, it's still fluid. Everybody's waiting and watching how things unfold. And the prices that go up, do they immediately come down or does it take some time then for the prices to gradually settle down? It gradually settles down. Initial impact is when you have a choke point and when you have a situation of backlogs, obviously the vessels will need to be diverted to the other ports and then moving those containers from those transshipment ports back into uae, that's additional cost. So yes, if there is a long term, then the prices will continue to be long term. Throughout the conflict, Gulf states tried desperately to avoid being dragged in. The region also houses some of the world's largest oil and gas facilities, infrastructure that has been targeted in past attacks. Since then, Saudi Arabia and the UAE have worked to thaw relations with the Iranian regime even as they have deepened security ties with the United States. Badr Al Saf, a Gulf based geopolitical analyst and a professor at the Kuwait University, believes that the recent conflict will push Gulf states to double down on improving ties with Tehran.

[Monica Nicholsburg]

Look, the Gulf states have been pursuing.

[Joshua McNichols]

A nimble foreign policy that caters to fast changing dynamics, that advances their security, their national interests, that also advances their domestic needs. And those plans require peace and stability.

[Sameer Hashmi]

In a region trying to chart a new course away from oil towards innovation and growth. Stability is currency in Dubai. Hello, I'm the BBC Sameer Hashmi for marketplace.

[David Brancaccio]

Early detection of breast cancer is the key. Those 40 and older can get annual mammograms paid for by their health insurance. But for roughly half, mammograms have a harder time detecting cancer. They have dense breast tissue that requires additional screening and that extra Screening is not always covered by insurance. Reporter Golda Arthur has more.

[Joshua McNichols]

Most women find out they have dense breast tissue when they get their mammogram results. Letter New Yorker Michaela Birmingham found out a couple years ago.

[Advertiser]

The letter did explain that it's common and that you just have to, you know, follow the proper recommended checkups to.

[Joshua McNichols]

Make sure that nothing's missed. Mammograms can miss signs of cancer in dense breasts, the tissue shows up as white and so do any tumors. Birmingham follows up with ultrasounds, which are more accurate, and says she's lucky her insurance company pays for that additional screening. But not everyone's that lucky.

[Advertiser]

Definitely people fall through the cracks.

[Joshua McNichols]

Dr. Julie Gershon is a Connecticut radiologist. In private practice.

[Advertiser]

The screening ultrasound should be considered a medical necessity for screening for breast cancer.

[Joshua McNichols]

But Dr. Gershon says not all insurers agree. She frequently has to get into a back and forth with insurance companies about getting those ultrasounds paid for.

[Advertiser]

We just did invoices last week and already I have two patients calling me about why their screening ultrasounds weren't paid for.

[Joshua McNichols]

Those tests can cost patients more than $300 out of pocket, and if an ultrasound doesn't paint a clear picture, they could be on the hook for about $1,000 for an MRI. Rhode island resident Jenny Hetzel Silbert says she fought her insurance company over the cost of her ultrasounds every year for three years. I filed my appeals.

[Advertiser]

It was months and months of getting.

[Joshua McNichols]

Intimidating letters and bills. It was on the fourth year that.

[Advertiser]

I was actually diagnosed with cancer.

[Joshua McNichols]

Silber testified before the Rhode island state legislature in 2023 on behalf of a bill aimed at forcing insurers to pay for follow up screening. It passed, making Rhode island one of 35 states with similar laws. Now the issue has become a conversation in Washington. Several bipartisan bills aim to help patients pay for screenings.

[Advertiser]

There's reform. Congress is coming together. You don't often hear about them working together, but they there are some issues that they agree on.

[Joshua McNichols]

Jessica Baladad is the founder of an organization called Feel for your Life and a breast cancer survivor until Congress acts. Her advice to people facing high out of pocket costs for screening is to find out what their state requires insurance companies to pay for and to stay informed on their rights as a patient. In New York. I'm Golda Arthur for Marketplace and a.

[David Brancaccio]

Person'S crypto holdings could soon help them get a federally backed home loan. The Federal Housing Finance Agency chief suggested this week that bitcoin and the like soon be considered when evaluating creditworthiness for mortgages through Fannie Mae or Freddie Mac. Crypto doesn't count at the moment. With the View, its value had less of a track record and was maybe less predictable. I'm David Brancaccio. This is the Marketplace Morning Report. We're from apm, American Public Media.

[Monica Nicholsburg]

Hey there, it's Ryan, co host of Million Bazillion, a podcast that answers your kids big questions about money. This week we're kicking it old school and taking questions from million Bazillionaires on this super special show.

[Joshua McNichols]

I was wondering how much people in the government, like the president make and how do they decide? How do airlines determine the price of a ticket? Where did the penny get its name?

[Monica Nicholsburg]

Plus, Bridget and I put some old cassette tapes to good use. Listen to Million Bazillion wherever you get your podcasts.