Blue state's new cancer bill could set new precedent across America

Dr. Carrie Frederick can think of many instances over her 14 years in practice in Oregon when patients tried to negotiate their way out of diagnostic testing for cervical cancer because of the expense.

The testing, which typically comes after someone already had an abnormal screening, can range from $200 to $1,200 out of pocket.

Oregon is set to become the first state in the country to require insurers to cover those costs for cervical cancer patients, and that policy could expand nationwide if a new federal regulation takes effect at the start of next year.

Both chambers of Oregon’s legislature passed the bill unanimously on Wednesday, Feb. 25, and it awaits Democratic Gov. Tina Kotek’s signature or veto. The measure will become law within a week even if she does not sign it, and it would apply to plans beginning Jan. 1, 2027.

Cervical cancer is one of few types of cancer that can be treated in a precancerous stage, which is why screenings are recommended every three to five years for women between the ages of 21 and 65. It’s also a cancer that experts have said is preventable, with the availability of the HPV vaccine for people under the age of 26, ideally before they are exposed through sexual activity to the virus that most often causes cervical cancer.

Advocates say broad access to low-cost or free reproductive health care helps prevent cervical cancer for the most vulnerable populations. But many clinics that offer that service have had to close or limit services in the past year and a half after the U.S. Congress approved steep cuts to Medicaid.

Oregon has a lower rate of cervical cancer per year than many other states. Jane Leo, Oregon government relations director for the American Cancer Society Cancer Action Network, said there were 140 cases diagnosed statewide in 2025, with the same or more expected in 2026. The organization estimates there were 13,360 new cases diagnosed nationwide in 2025.

Leo said the cancer advocacy organization aims to remove cost sharing on all diagnostic treatments for cancer nationwide, and bills like Oregon’s are an important step.

“I’m hoping my colleague in Washington will be pushing for it now,” Leo said. “It has to start somewhere, and I’m proud that Oregon was the first state to do it.”

When a routine Pap smear screening flags abnormal cervical cells, an OB-GYN can only gather more information about whether those cells are cancerous by conducting a more thorough examination called a colposcopy. That procedure is more targeted, and Frederick said the medical community recommends taking up to four biopsies, which are sent to a separate lab facility. Each biopsy has its own cost.

“I’ve definitely found myself bargaining internally, like, can I get away with two biopsies so this patient doesn’t end up with a bill?” Frederick said.

Frederick is a former legislative chair for the American College of Obstetricians and Gynecologists, and started assisting with the development of the Oregon bill in 2023. That was the year Oregon passed a similar law related to breast cancer diagnostic costs, and Frederick said they used that bill as a template.

The cervical cancer testing bill was introduced for a third time in February, and its importance was punctuated by Oregon Rep. Annessa Hartman’s ongoing treatment for Stage 3 cervical cancer, which she announced in November.

The Health Resources and Services Administration published new federal rules at the beginning of January related to screening for cervical cancer. Along with new guidance related to at-home testing, it included a requirement that most insurance plans must cover follow-up testing without cost sharing.

Dr. Julia Barnes, legislative chair in Oregon for the American College of Obstetricians and Gynecologists, said there was some confusion about whether the legislation was still necessary after the new guidance was released, but they decided it should still be codified at the state level.

“It gives Oregon the authority to actually enforce it, and federal guidelines can change,” Barnes said.

The law creates minimal or no fiscal impact to Oregon’s budget, assuming the federal guidance takes effect in January, Barnes said, which helped the bill pass without any opposition.

The law is one step toward lowering the rates of cervical cancer, which caused 50 deaths in Oregon out of the 140 diagnosed, according to the American Cancer Society. Barnes said those who are treated and survive have lingering effects from radiation on vaginal tissue and complicated surgeries.

“It’s just really awful when you see people who have either delayed follow-up because it’s going to cost them, or they’re not aware, or they missed the window to get the vaccine,” Barnes said. “We are totally thrilled that this passed. It’s been a long time coming.”