Pennsylvanians with state-regulated health insurance plans, like those sold on the Affordable Care Act marketplace, will now be able to get colon cancer screenings at no cost starting at age 45 instead of 50.
A new law passed by the Pennsylvania legislature with bipartisan support and signed by Gov. Josh Shapiro on Oct. 22 expands the minimum age eligibility for full coverage of routine screenings, which can include colonoscopies, stool test kits and blood tests.
Champions of the new law, like state Rep. Pat Gallagher, D-Philadelphia, hope that it will help more people access early screening and catch colon cancer at earlier stages.
"It's one small step to a greater step to get people early detection," said Gallagher, who was a lead sponsor of the bill and is a colon cancer survivor. "And I keep going back to early detection, because it is a treatable, curable cancer if detected early."
The law takes effect in December and will apply to most state-regulated insurance plans by 2028.
Changes in screening recommendations as colon cancer rates rise
The American Cancer Society updated its colon cancer screening guidelines in 2018, which recommend that screenings start at age 45 instead of 50. Disease rates among people under 50 have risen rapidly in recent years, data shows.
The U.S. Preventative Services Task Force, an independent panel of scientists and experts in disease prevention, made the same recommendation in 2021. Federal agencies adopted the change, which meant all private health insurance plans had to cover the screenings at no cost for eligible patients.
However, that left a gap for people with state-regulated insurance plans, who might still be charged for a screening test if they were under 50 and had no documented history of colon cancer in their family.
"If you fell into those gaps, insurance companies don't like paying preventative maintenance," Gallagher said.
Efforts to catch colon cancer earlier in younger adults
The new Pennsylvania law will close those insurance gaps, he said, but noted that it doesn't address the fact that there are many adults even younger than 45 who could benefit from a free screening test.
Gallagher himself was diagnosed with late-stage colon cancer at 45, which meant the disease was likely growing, undetected, long before he ended up in the hospital with serious stomach pain in early 2020.
"They thought it was originally diverticulitis and they were going to remove half my colon. And when they went in there, they found four tumors," he said. The discovery led to multiple surgeries, a temporary colostomy bag and chemotherapy.
Gallagher estimates that his insurance paid out close to $1 million for his care, which was extensive given his late-stage diagnosis. He compares that to the average $2,500 it might cost insurers to cover a screening colonoscopy, which can detect cancer at earlier stages that are often less costly to treat.
"What I went through was brutal," he said. "But if we can avoid that, and even avoid insurance companies having to pay for all these treatments, you would think that would be the way it should be."
State Rep. Jordan Harris, who represents parts of West and Southwest Philadelphia in the Pennsylvania House, has also questioned whether the state and insurance companies are doing enough to prevent colon cancer deaths in younger people.
Harris' late wife, Tiffany Harris, died in 2024 from the disease. She was only 36 years old. During legislative hearings, the representative said he didn't think his wife would have been considered high risk prior to her diagnosis, and that if she had access to routine screening, her case may have been caught earlier.
"I know what happens when this disease goes undetected for too long. No family in Pennsylvania should have to experience that same pain," Harris said in a statement after the bill gained final passage in the legislature last month.
Lawmakers and cancer survivors said they're preparing to try and get the recommended minimum age for routine colon cancer screenings down even more. Gallagher said lowering it by another five years could be significant. He plans to introduce legislation to that effect next term.
"I don't know if we'll ever get to 35, at least not in my lifetime. I think that would be a Herculean lift," he said. "But I do think we can go back and get it to 40, which I think is important."
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