A Step Forward Against Step Therapy In Breast Cancer Care

So many of us have watched someone we love endure the battle against breast cancer. A dear friend of mine is going through treatment right now, and her journey is a daily reminder of the courage it takes to fight this awful diagnosis and of how many families are touched by this disease each year. In the United States alone, more than 300,000 women will be diagnosed with breast cancer in 2025. Behind each statistic is a person, a family, and a story.

Every October, Breast Cancer Awareness Month brings pink ribbons, fundraising walks, and survivor stories that remind us of the progress we’ve made but also of the work that lies ahead. Awareness is important, but action is essential.

Earlier this year, I sponsored Senate Bill 921 to make sure compassion – not bureaucracy – guides cancer care in Maryland. For too long, patients with advanced metastatic cancer were forced to endure insurance rules known as “step therapy” or “fail-first” protocols. These rules made patients try – and fail – on less effective treatments before insurers would cover the medication their doctor originally prescribed. While Maryland law had already banned step therapy for certain cancer drugs, it did not protect patients when it came to the medications needed to manage the painful symptoms and side effects of stage 4 cancer.

Senate Bill 921 closes that gap. Beginning in 2026, if a doctor prescribes a medication to ease nausea, control pain, or manage the debilitating effects of late-stage cancer, insurers will no longer be able to stand in the way with red tape. Patients will be able to get the care they need without delay.

The most powerful voices in this fight were survivors and advocates like Rachel Joseph, a two-time breast cancer survivor with the Susan G. Komen Foundation. She testified with incredible grace and shared not only her own story but also that of her dear friend Diane, who passed away from metastatic breast cancer. Rachel told us it was a privilege to testify, but one Diane never had because she ran out of time. Diane’s story drove home the truth that inspired this bill: No one should lose precious moments battling insurance bureaucracy when they are already fighting for their lives.

As we mark Breast Cancer Awareness Month, let’s honor survivors, remember those we’ve lost, and recommit ourselves to policies that put compassion at the center of health care. And let’s also take personal action. If you are due for a mammogram, please don’t wait. It’s one of the most powerful tools we have to detect breast cancer early and save lives.