Metastatic Breast Cancer Access to Care Act
- Sponsor
- Rep. Garbarino, Andrew R. [R-NY-2]
- Committees
- Ways and Means Committee (primary)
- Last action
- Mar 11, 2025
Bottom line
The bill provides immediate access to disability benefits and Medicare for individuals with metastatic breast cancer by waiving existing waiting periods.
What it actually does
This bill eliminates the standard waiting periods for Social Security Disability Insurance (SSDI) benefits and Medicare coverage for individuals diagnosed with metastatic breast cancer. Currently, most individuals must wait five months for SSDI benefits and an additional 24 months for Medicare coverage after becoming eligible for disability. This legislation would grant immediate access to both for those with metastatic breast cancer.
Proponents argue
Supporters argue that individuals diagnosed with metastatic breast cancer face a severe, often terminal, illness and should not endure lengthy waiting periods for essential financial support and medical care. Eliminating these waiting periods would provide crucial relief during a time of immense physical and financial strain, ensuring timely access to treatment and income replacement.
Opponents contend
Critics might express concerns about the precedent of creating specific exceptions for individual diseases, potentially leading to an inequitable system where some conditions receive preferential treatment over others. They may also raise questions about the long-term fiscal impact on the Social Security and Medicare trust funds by accelerating benefit payouts without corresponding revenue increases.
The bill is exceptionally short and clear, making it very accessible for any reader to understand its core provisions quickly.
Section 2
Elimination of Waiting Period for Disability Insurance Benefits
This section amends Section 223(a) of the Social Security Act to include metastatic breast cancer alongside amyotrophic lateral sclerosis (ALS) as a condition for which the standard five-month waiting period for disability insurance benefits is waived. This means individuals with metastatic breast cancer would begin receiving their disability benefits immediately upon approval, rather than waiting five months.
Supporters argue
Proponents argue that this provision offers vital financial support to individuals facing a life-threatening illness, allowing them to focus on treatment and well-being without the added stress of a delayed income stream. It acknowledges the severe and often rapid progression of metastatic breast cancer.
Critics contend
Opponents might contend that while the intent is compassionate, creating disease-specific exceptions could lead to an uneven system. They may also raise concerns about the cumulative fiscal impact of waiving waiting periods for an increasing number of conditions on the Social Security Disability Insurance trust fund.
Tradeoffs
The provision balances the immediate needs of severely ill individuals against concerns about program equity across different diseases and the long-term fiscal sustainability of the disability insurance program.
Section 3
Waiver of 24-Month Waiting Period for Medicare Coverage
This section amends Section 226(h) of the Social Security Act to waive the 24-month waiting period for Medicare coverage for individuals with metastatic breast cancer. Currently, after becoming eligible for disability benefits, individuals typically wait two years before their Medicare coverage begins. This amendment would grant immediate Medicare access for those with metastatic breast cancer, similar to the existing waiver for ALS patients.