Experts Debate Breast Cancer Screenings

"In much of the country, insurance coverage for mammographic screening is mandated by law. For women in these areas, there will be no immediate change," said Dr. David Dershaw, director of Breast Imaging at Memorial Sloan-Kettering Cancer Center. "As the American Cancer Society has stated that this report will not result in any modification of its screening recommendations, hopefully insurance coverage will not be changed."

Would Insurance Coverage for Mammograms Change?

Forty-nine states mandate that health insurance companies cover routine mammograms. The laws vary from state to state on whether the insurance company pays all or part of the costs, but the vast majority require a baseline mammogram for an insured woman at age 35 and above, routine mammograms every two years for women age 40-49 and annual mammograms for women older than 50.

The law does not apply to millions of women who get insurance through an employer who is "self-insured," meaning the employer pays for the health care but a third party health insurance group manages the care.

Still, laws mandating mammogram coverage in all states, except Utah, pack a powerful punch. The USPSTF also recommends mammograms be performed on an individual basis, if the doctor recommends one.

Health insurance lobbyist group America's Health Insurance Plans, doesn't foresee a change in coverage soon.

"We don't believe that payment will vary depending on whether a woman who gets a screening is in the target age group or outside the target age group," said Susan Pisano, vice president of communications for AHIP.

What Insurers Will Do With New Mammogram Recommendations

Pisano predicts that health care groups will stop encouraging women in their 40s to get yearly mammograms and will refocus those targeting efforts -- such as sending reminder postcards to get a mammogram -- to women in their 50s. But that doesn't mean women in their 40s or younger would not be covered.

"Occasionally, a woman who is not high risk, and she's 32, wants it done," Pisano said. "In those cases, the woman might have a discussion with her doctor and talk about the risks and benefits. ... At the end of the discussion, if the doctor orders a mammogram for that woman, then it's typically covered."

Other Recommendations by the USPSTF

The task force also recommends against teaching breast self-exams for all women and said evidence was insufficient to recommend mammograms for women older than 74.

The recommendations were only for women considered to be at normal risk for breast cancer. Women who are at a known high risk -- for instance, women who tested positive for the BRCA-1 and BRCA-2 genes -- would not fall under the guidelines.

Family doctors often abide by the task force's recommendations in their practices, and insurance companies routinely turn to USPSTF -- a panel of independent medical experts -- to guide coverage plans.

ABC News' Reynolds Holding contributed to this report.

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