Who Should Pay the Cost of Genetic Testing?

The “Angelina effect” has prompted a new wave of cancer testing; patients and insurers are squaring off over payments.

Angelina Jolie underwent a double mastectomy in 2013 for preventive purposes. She had learned she carried mutations in the BRCA1and BRCA2 genes, which give women a higher risk of developing aggressive breast and ovarian cancers. Since her much-publicized decision, interest in genetic testing for cancer risk has soared.

Some 40 genetic mutations have been linked to the risk of developing cancer, but only about 5 percent of cancers in the U.S. have a genetic link. The Affordable Care Act requires insurers to pay for testing to identify BRCA1 and BRCA2 mutations in women with a family history of breast cancer. Some insurers refuse to pay for other genetic tests, saying their effectiveness in cancer prevention and detection is unproven.

Researchers say that the refusal to pay creates a Catch 22 situation. Patients who might benefit don’t get tested because they can’t afford it. That makes the pool of people who have been tested too small to allow researchers to reliably assess testing’s effectiveness.

Should your health plan cover genetic testing? Comment below to discuss this and other preventive care benefits.

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