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Advocacy and Policy Landscape on Breast Screening Access

Across the United States, policies on breast cancer supplemental screening access vary widely, creating significant gaps in coverage and equity. While national guidelines set basic screening recommendations, it is state-level policies and insurance rules that often determine whether women have access to the full range of screening options, especially for those with dense breasts and other high-risk factors.

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National breast screening policy

National 

National Breast Screening Policy Overview​

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  • Screening Guidelines: Federal recommendations advise mammograms every two years starting at age 40 for women at average risk.

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  • Insurance Coverage: Most private insurance plans must cover these routine mammograms at no cost under the Affordable Care Act.

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  • Dense Breast Notification: As of 2024, providers must inform women if they have dense breast tissue, which can make mammograms less effective.​​

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The notification encourages women to discuss their breast density and screening options with their healthcare provider, but it does not require insurance to cover additional tests.

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Colorado breast screening policy

Colorado

Colorado Breast Screening Policy Overview

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  • Notifies women about dense breast tissue after mammograms.

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  • Requires state-regulated insurance plans (individual and small group markets based in Colorado) to cover supplemental imaging at no out-of-pocket cost starting in 2025 for women with dense breasts or other risk factors (e.g., family history, genetic predisposition, high-risk models).

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Discover our collaboration with stakeholders and policymakers to bridge the care gaps for women in Colorado. 

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California Breast Screening Policy

California

California Screening Policy Overview

  • Notifies women if they have dense breasts.

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  • No state mandate for insurance coverage of supplemental imaging, meaning many women pay out-of-pocket, even if at higher risk.

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Supplemental breast screening access in California, more information:

Wisconsin Breast Screening Policy

Wisconsin

Wisconsin Screening Policy Overview

  • Notifies women if they have dense breasts.

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  • No state mandate for insurance coverage of supplemental imaging, meaning many women pay out-of-pocket, even if at higher risk.

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Supplemental breast screening access in Wisconsin, more information:

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