Progress, Persistence, and the Path to Equity in Breast Cancer Screening

Access shouldn’t determine outcomes. Equity saves lives.

In June 2026, Arizona took a significant step forward. Governor Katie Hobbs signed SB1165 (Breast Cancer Screening Continuum) into law, a bill that prohibits health insurers from imposing cost-sharing requirements for preventive breast cancer screenings and follow-up diagnostic services. This means that for many Arizonans, starting January 2027, the financial barrier to a mammogram or a necessary follow-up exam will be removed.

This is a victory worth celebrating! But it's not the finish line, we still have more work to do.

While this law addresses the cost of care, it doesn't solve the problem of access. SB1165 applies to state-regulated health plans, meaning it covers certain people but not everyone. It does not solve the persistent disparities in screening rates that continue to cost lives.

A Deeper Look at the Disparity

The statistics paint a clear picture of inequality. In Arizona, only 64% of women get their recommended mammograms, and that percentage drops significantly for minority women and those in underserved communities. In fact, the 2020 breast cancer screening rate for uninsured individuals in the state was just 42%, compared to 63% for the general population. Nationally, Black women experience approximately 40% higher breast cancer mortality than white women, and research shows that this disparity is largely driven by socioeconomic factors, not race alone.

The reasons for this gap go far beyond cost:

• Location and Logistics: For many, getting a mammogram means taking time off work, finding transportation, and traveling long distances to an imaging center. Inconvenience is a frequent barrier.

• The "Referral Gap": Even when a doctor provides a referral, it's often not enough. A quality improvement initiative at a student-run free clinic in Arizona found that while a referral workflow modestly improved screening rates, persistent barriers like transportation, language discordance, and fear of screening meant they still fell short of their target.

• Follow-up Care: The disparity doesn't end with the screening. Research shows that racial and ethnic minorities are less likely to receive diagnostic imaging on the same day as an abnormal mammogram, leading to delays in diagnosis and a poorer prognosis.

Why We Can't Stop with One Law

SB1165 is a game-changer because it removes the financial fear that can deter women from getting follow-up tests after an abnormal result. As one breast cancer survivor and advocate, Maria Martinez, put it, "Many women need additional exams after an abnormal mammogram, but they can't always afford them." This law ensures the "full continuum" of care is covered, preventing financial hardship from delaying a diagnosis. It's exactly the kind of policy we've been fighting for.

Even with this law, there are still women who need help. Women who are uninsured. That's where Check for a Lump comes in.

Our mammogram and diagnostic testing program exists to complement this law. We reach the women who, for whatever reason, still don’t have insurance. We provide the navigation, the follow-up, and the support that a piece of legislation alone cannot offer. And we do it with the same goal in mind: making sure every woman has a fair shot at early detection.

While legislation is vital, community-based programs, like our mammogram program, are often the ones on the front lines, directly addressing the access problems that persist even after a bill becomes law. These initiatives show us what works.

Mobile Mammography in Partnership with Check for a Lump

One of the most powerful tools in closing the access gap is bringing screening directly to the communities that need it most. Through our mobile mammography partnerships, Check for a Lump eliminates the barriers of distance, transportation, and time that keep so many women from getting their annual screening. By meeting women where they are, we remove the excuse of "I can't get there" and replace it with a simple, accessible "right here, right now." And because every screening we facilitate is fully funded through our program, there is never a bill, never a copay, and never a surprise charge, just care, delivered with dignity.

Closing the Diagnostic Gap

Where many programs stop at screening, Check for a Lump goes further. We recognize that the diagnostic phase, ultrasounds, biopsies, MRIs, is where the system often fails the most vulnerable. These tests are significantly more expensive than a screening mammogram, and without coverage, many women simply walk away. By funding the entire continuum from first screen to definitive diagnosis, or “all clear”, we ensure that no woman is left wondering, waiting, or worrying because she couldn't afford the next step.

The Path Forward

We are proud of SB1165. We worked for it, we advocated for it, and we will continue to champion policies that remove barriers to care. This law is a testament to what's possible when communities come together.

But we also know that policy is only one piece of the puzzle. True equity in breast cancer screening requires a multi-pronged approach:

1. Continue to fund and expand programs like mobile mammography, patient navigation, and direct assistance initiatives like Check for a Lump that address the barriers of access, cost, and continuity of care.

2. Support and expand the reach of safety-net programs like the Well Woman HealthCheck Program, which offers free screenings regardless of documentation status.

3. Keep advocating for policies that close the remaining gaps, building on the momentum of SB1165 to ensure that no woman is left behind.

Access shouldn't determine outcomes. We've made incredible progress, and we're not stopping now. Together through legislation, community programs, and everyday advocacy we will ensure that every woman, regardless of her zip code, insurance status, or background, has the opportunity for early detection. Equity isn't just an ideal; it's a life-saving necessity. And we're proud to be part of the solution, every step of the way.