Download DATE Governor Jerry Brown c/o State Capitol, Suite 1173

DATE
Governor Jerry Brown
c/o State Capitol, Suite 1173
Sacramento, CA 95814
RE: AB 1763 (Gipson) – Support
Dear Governor Brown:
On behalf of (NAME OF ORGANIZATION) we are writing to urge your signature on Assembly Bill
1765 (Gipson), to eliminate cost-sharing for patients who need follow-up colonoscopies after a positive
stool screening test.
Colorectal cancer (CRC) is the second leading cause of cancer deaths in the United States but is the most
preventable and curable cancer if the eligible population is screened as recommended. Screening allows
for early detection and can decrease CRC incidence and mortality significantly. The uninsured and
underinsured are least likely to get screened and most likely to be diagnosed at a late, incurable, stage.
While CRC incidence has decreased among all four major racial/ethnic groups, screening rates among
those in poverty and among Hispanics and African Americans remains low. CRC incidence is higher
among California’s African Americans and Asian/Pacific Islanders. Colorectal cancer is the third most
common cancer in both black men and women.
The Affordable Care Act (ACA) requires all private insurers to cover preventive services that receive an
A or B rating from the United States Preventive Services Task Force (USPSTF) without any patient costsharing. The 2016 United States Preventive Services Taskforce (USPSTF has assigned colorectal cancer
screening an “A” rating and recommends several screening tests as covered. These include: CT and
optical colonoscopy, sigmoidoscopy, the high-sensitivity fecal occult blood tests: sensitive guaiac test
(FOBT) and fecal immunochemical test (FIT) and the FIT/DNA test. Screening with any of these tests is
recommended for adults age 50 and older until age 75.
High-sensitivity FOBT and FIT tests are effective, non-invasive, easily accessible, and safe screening
tests that are more cost efficient than colonoscopies. However, a positive test result requires that a followup colonoscopy be provided. Health plans often require patients to pay out-of-pocket cost-sharing for the
follow-up colonoscopy which can be a barrier to patients completing their CRC screening. Multiple
studies have shown that individuals are less likely to seek health services, including preventive
screenings, when they are required to pay for those services out-of-pocket. Additionally, research has
shown that limiting colorectal cancer screening choices to only colonoscopy can result in a lower
colorectal cancer screening completion rate compared to providing a choice between colonoscopy and a
stool-based test, particularly among racial and ethnic minorities.
(ORGANIZATION NAME) supports AB 1763 because (ENTER INFORMATION ABOUT HOW THIS
BILL IMPACTS YOUR ORGANIZATION OR WHO YOU REPRESENT). For these reasons,
(ORGANIZATION NAME) urges your signature on AB 1763.
Sincerely,
YOUR NAME
ORGANIZATION