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American Bar Association Commission on Women in the Profession

Breast Cancer Legal Advocacy Initiative - Payment for Breast Reconstruction Is Mandated by ERISA

The amendments to ERISA provided for by the Women's Health and Cancer Rights Act of 1998 provide that health insurers who provide coverage for mastectomy must also provide coverage for breast reconstruction. 29 U.S.C. §1185b. Furthermore, "[n]othing in this section shall be construed to preempt any State law in effect on the date of enactment…with respect to health insurance…that requires coverage of at least…reconstructive breast surgery otherwise required under this section." 29 U.S.C. §1185b(e)(1). Thus, state laws mandating more complete coverage than this law will not be preempted by ERISA.

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