Fox Guest Claims Obamacare Changing Breast Cancer Recommendations To Ration Care

Fox Guest Dr. Held: Obamacare Recommends “Don't Even Start Your Mammograms Until Age 50.” On Fox & Friends, co-host Elisabeth Hasselbeck discussed mammogram recommendations with Dr. Kristen Held. Held claimed that, because of the Affordable Care Act, the U.S. Preventative Services Task Force “said don't even start your mammogram until age 50” and added that it would ration care for the elderly:

HELD: Obamacare takes a disproportionate hit on cancer patients. And if you look at breast cancer, one out of eight women diagnosed with it in our lifetime, but we have the longest survival rates and the earliest diagnosis rates because of mammogram. Well, Obamacare has panels and task forces which have changed the very recommendations.

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HELD: Well, traditionally, the American Cancer Society and [unintelligible] care is to have a mammogram every year starting at age 40. Well, this task force came in without a single breast cancer specialist on it and said don't even start your mammograms until age 50 and then every other year until 74 and then stop. What's really surprising is that a study recently showed that these younger women have a higher death rate. These are young women who have kids at home, they're active professionally, and particularly African-American women are most commonly hit in this young age group, and they're more likely to die of breast cancer. And now we have recommendations not even to get the mammograms when we know that delaying your diagnosis increases your chances of dying from cancer. [Fox News, Fox & Friends, 9/25/13]

ACA Rejected Task Force's Recommendation, Funds Mammograms Starting At Age 40

ACA Contains “Specific Repudiation” Of Task Force Recommendation On Mammography. Reporting on a speech by task force vice chairwoman Dr. Diana Petitti, the NIH Record, a newsletter published for employees of the National Institutes of Health, points out that the ACA covers mammograms for women starting at age 40 and ignored the task force's 2009 recommendation:

Meanwhile the ACA, which became law in March 2010, contained a specific repudiation of the task force's new guidelines:

"...the current recommendations of the United States Preventive Service Task Force regarding breast cancer screening, mammography and prevention shall be considered the most current other than those issued in or around November 2009," according to the statute.

Result: For women over 40, routine screenings every 1 to 2 years must be included in coverage plans without a copayment or co-insurance. The section of the law that deals with Medicare contains similar wording. [NIH Record, 9/13/13]

Task Force's Recommendations Were Non-Binding And From An Independent Agency

NEA Health Information Network: Task Force's Non-Binding Recommendations Aimed At Reducing" False Positives." The NEA Health Information Network published a fact sheet which explained that the U.S. Preventative Services Task Force's recommendations were non-binding, but would reduce the number of women taking unnecessary treatment:

When the U.S. Preventive Services Task Force called for raising the age for regular mammograms from 40 to 50, and also recommended that older women cut back to one scheduled exam every other year, it raised a firestorm of  debate - and confusion. The task force said its non-binding recommendations would reduce the number of falsepositives (which occur in about 10 percent of mammograms) and prevent many women from undergoing unnecessary surgery, chemotherapy, and radiation. [NEA Health Information Network, accessed 9/25/13]

NBC's Snyderman: “It's Important To Remember That These New Recommendations From This Independent Task Force Are Just That -- They're Recommendations.” In a Nightly News report on the task force recommendations, NBC chief medical correspondent Dr. Nancy Snyderman stated, “It's important to remember that these new recommendations from this independent task force are just that -- they're recommendations. They don't mandate any changes in who should get mammograms and when.” [NBC,Nightly News with Brian Williams, 11/17/09]

NY Times: “The Task Force Is An Independent Panel Of Experts In Prevention And Primary Care.” The New York Times reported that the task force is an individual panel of experts who recommended that “Most women should start regular breast cancer screening at age 50, not 40.” The article noted that the recommendations did not apply to women at high risk for breast cancer:

The task force is an independent panel of experts in prevention and primary care appointed by the federal Department of Health and Human Services.

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Dr. Diana Petitti, vice chairwoman of the task force and a professor of biomedical informatics at Arizona State University, said the guidelines were based on new data and analyses and were aimed at reducing the potential harm from overscreening. [The New York Times, 9/16/09]

Task Force's Recommendation Was Not A Ban On Mammograms  

Task Force Did Not Recommend Blanket Ban On Mammograms For Women Under 50. The task force issued a grade C recommendation “against routine screening mammography in women aged 40 to 49 years” and stated that "[t]he decision to start regular, biennial screening mammography before the age of 50 years should be an individual one and take into account patient context, including the patient's values regarding specific benefits and harms." As a grade C recommendation, clinicians are counseled to "[o]ffer or provide this service only if other considerations support the offering or providing the service in an individual patient." [Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement, 9/17/09]

Task Force Encouraged Policymakers To Include Additional Considerations And “Individualize Decision Making To The Specific Patient Or Situation.” In publishing its updated recommendations in The Annals of Internal Medicine, the task force acknowledged that other considerations should be included in determining what preventive treatment to provide, stating, “The USPSTF recognizes that clinical or policy decisions involve more considerations than this body of evidence alone. Clinicians and policymakers should understand the evidence but individualize decision making to the specific patient or situation.” [Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement, 9/17/09]

Task Force Did Not Recommend That Mammograms Be Halted At Age 74. Contrary to Held's claim the task force recommended that mammograms “stop” at age 74, the task force stated only that “the current evidence is insufficient to assess the additional benefits and harms of screening mammography in women 75 years or older.” [Screening for Breast Cancer: U.S. Preventive Services Task Force Recommendation Statement, 9/17/09]

Fox News Failed To Disclose Guest's Association With Anti-Obamacare Group

Fox & Friends Failed To Disclose Kristin Held Is The Co-Founder Of American Doctors 4 Truth. During the Fox & Friends segment, Held was identified only as a “breast cancer survivor.” It was not mentioned that Held is a co-founder of American Doctors 4 Truth, a group critical of the ACA. [American Doctors 4 Truth, accessed 9/25/13]

American Doctors 4 Truth: “We Have Waited Too Long For A National Voice To Inform The Average American Citizen About The Hazards Of The New Health Care Law.” American Doctors 4 Truth is an organization dedicated to opposing and repealing the Affordable Care Act:

We believe that the doctors who actually care for America's patients have valuable insight and wisdom to share. We have waited too long for a national voice to inform the average American citizen about the hazards of the new health care law and to lead the way with reform. The time for waiting is over. This website is the beginning of such a voice. [American Doctors 4 Truth, accessed 9/25/13]

Fox Hosted American Doctors 4 Truth Co-Founder Jane Hughes On Fox & Friends The Day Before. On September 24, the day before Held's appearance, Fox & Friends hosted Dr. Jane Hughes, co-founder and director of American Doctors 4 Truth, to claim that Obamacare was “sticking it to men.” Hughes was identified as being with the group. [Fox News, Fox & Friends, 9/24/13, via Media Matters]