ASPS Advocacy Efforts Breast Reconstruction Patient Education Act

ASPS is pushing laws that will give every breast cancer survivor insurance coverage for their preferred breast reconstruction approach.

Breast cancer is consistently at or near the top of the list of most common cancers, with more than 300,000 cases now occurring each year. Nearly everyone has a mother, a daughter, a sister, a spouse, a friend or a colleague they love and admire who has faced this disease.

Fortunately, breast cancer has a very high overall five-year survival rate. But for many survivors, true recovery isn't finished until breast reconstruction is complete.

Fortunately, federal law requires insurance plans that offer breast cancer coverage to cover breast reconstruction as an essential part of care.

Unfortunately, not all health insurance companies follow that federal law the way it was intended.

When that law – the Women's Health and Cancer Rights Act (WHCRA) of 1998 – was passed, it marked a breakthrough for cancer survivors. At that time, some women struggled to access things as basic as a hospital stay after a mastectomy, and insurance medical directors were brazenly telling a United States senator that "replacement of a breast is not medically necessary and not covered under the plan," and that a breast "cannot and should not be replaced." WHCRA's purpose was clear: to establish breast reconstruction as a required part of health insurance coverage and to guarantee that women could choose, with their surgeon, the best treatment option.

However, the original law reflects treatment options and standards from 25 years ago. Since then, surgical breast cancer treatment has advanced in amazing ways that were not even fully contemplated when the law was enacted. Over that same time, there have been amazing advances in surgeons' ability to repair any level of defect caused by removing cancer, including their ability to give a new breast sensation through regenerated nerves, and in surgeons' ability to treat complications that can come after breast reconstruction.

To uphold the spirit and intent of WHCRA, ASPS has been working to modernize the original law to clearly state that its coverage guarantees apply to all medically appropriate forms of post-breast cancer reconstruction, including reconstruction following breast-conserving surgery (e.g., lumpectomy, partial mastectomy, etc.), which was not included at all in the original law. The goal is to ensure that each patient receives what she wants from all the options available to meet her needs. Whether it is a technically advanced procedure, such as microsurgical tissue-based reconstruction, implant-based reconstruction, an aesthetic flat closure or a flat closure followed by the use of a custom-fabricated breast prosthetic, the Society's legislative approach explicitly includes the treatment choice under its coverage guarantees.

ASPS is currently working at the state and federal levels to advance legislation that modernizes health insurance coverage for breast reconstruction. If you are interested in learning more about these efforts, please contact advocacy@plasticsurgery.org.

Last updated on October 1, 2025.