When a woman hears the words, “You have breast cancer,” her world changes instantly.
In that moment, she is not thinking about insurance codes, provider networks, or reimbursement formulas. She is thinking about survival—about her children, about whether she will live to see her next birthday.
And yet, for too many women in Alabama, what follows cancer surgery brings a second battle—not against disease, but against their own health insurer.
Federal law has long recognized that breast reconstruction after mastectomy is not cosmetic. It is part of cancer treatment. Congress made that clear in 1998 through the Women’s Health and Cancer Rights Act, requiring health plans to cover breast reconstruction following mastectomy.
But in the years since, insurers have developed administrative and financial practices that can make those protections difficult to access in practice.
Across Alabama, women have shared stories of delayed approvals, limited surgeon options, and confusing administrative hurdles that left them exhausted at a time when healing should have been their only focus. Some have been forced to travel out of state for care that should have been available close to home.
These challenges are not theoretical. They are affecting patients in communities across our state.
Mobile plastic surgeon Dr. Mark Stalder told lawmakers he has seen insurers use reimbursement structures and network limitations that restrict access to the full range of reconstruction options. When qualified surgeons cannot sustainably participate in insurance networks, patients lose meaningful choice, even when coverage technically exists.
Some women are told that the reconstructive surgeon or procedure they believe is best for them is not covered—even though it is available here in Alabama and protected under federal law—and are instead directed to other providers. Others encounter so many administrative obstacles that they ultimately abandon reconstruction altogether.
The gap between what is legally covered and what is truly accessible is what this legislation seeks to address.
The bill does not create new benefits or expand mandates. Instead, it ensures that existing federal protections function as intended—allowing patients to understand their options, work with their physicians, and receive timely reconstructive care without unnecessary insurance barriers.
This is not a partisan issue. Cancer does not check party registration. The women who have come forward include Republicans, Democrats, and independents—mothers, teachers, business owners, and retirees—united by a simple message: the law promises coverage, but the system too often fails to deliver access.
No patient recovering from cancer should have to navigate technical loopholes or insurance obstacles to restore her body and her sense of wholeness. This healing does not affect women alone. I have heard from husbands across Alabama who want their wives to feel whole again after cancer—who see reconstruction not as vanity, but as part of restoring confidence, intimacy, and normalcy within a marriage that has already endured so much. When a woman is denied that opportunity, the loss is felt by families, not just patients.
Breast reconstruction is about healing—physically and emotionally. For many patients, it represents an essential step toward recovery and restoration after one of life’s most difficult diagnoses.
Our responsibility as lawmakers is straightforward: when a law guarantees care, patients should be able to receive it.
Alabama women should not have to leave their state, delay treatment, or abandon medically appropriate options because of insurance barriers. They deserve clarity, access, and dignity in their recovery.
Cancer takes enough. Our health system should not take more.
