Oct 15, 2025
By Mckenzie Richmond
Published: Oct. 15, 2025 at 7:43 AM PDT
Law takes effect January 1, advocates push for nationwide adoption
October is Breast Cancer Awareness Month, and a groundbreaking new law out of Oregon is expanding options for survivors.
Oregon Senate Bill 1137 is the first in the nation to guarantee access to advanced, muscle-preserving breast reconstruction surgery, even if it means going out of network.
This law marks a huge win for the thousands of breast cancer survivors across the state, and it all started with one woman from Bend.
“This was just me being a patient and being told no and I was told no twice, and that’s not okay,” said Gail Menasco.
After beating breast cancer, Menasco’s fight was far from over. She was told the type of reconstruction she wanted - a muscle-preserving procedure using her own tissue - wasn’t covered by her insurance.
“I was being quoted cash prices for my mastectomy and reconstruction,” he said.
The only options covered by insurance involved implants. But after having cancer, Menasco didn’t want anymore foreign objects in her body.
“I was so mad and devastated. I was face down on my front lawn grass, just crying, that I was forced into being flat when I didn’t want that for me. That wasn’t my choice” she said. “I had to fight, I had to figure out a way.”
That fight turned into a grassroots movement; no lobbyists, just patients working with lawmakers to change Oregon law.
Over the summer, Governor Tina Kotek signed SB 1137, making Oregon the first state to guarantee insurance coverage for advanced reconstructive surgeries like Deep Inferior Epigastric Perforator (DIEP) flap, which uses a woman’s own tissue to reconstruct.
According to local breast surgical oncologist Dr. Kati Dunham, these procedures are more natural, longer lasting, and often safer.
“Using your own tissue that has a lot less chance of either having an infection or having some sort of breakdown of the material,” said Dr. Dunham.
But the catch is that very few surgeons perform these surgeries.
“There’s not a ton of surgeons that are doing this procedure, you need a specialized microvascular plastic surgeon,” Dr. Dunham said. “Sometimes people do have to go out of state.”
Now, if local providers aren’t available to do the surgery, the law lets patients go out-of-network at in-network rates.
For some breast cancer survivors, the bill came too late.
“Unfortunately, insurance regulations really have women making a decision that they don’t want because they can’t afford it, their insurance doesn’t cover it,” said Adrienne San Nicolas, survivor and advocate for reconstruction access.
“Being told that you don’t fit the mold to get a surgery that you thought was your saving grace was almost worse than cancer,” said Tabitha Prather, who was denied coverage for reconstruction surgery.
San Nicolas and Prather, along with fellow survivor Courtney Daly, were all forced to pay out-of-pocket and travel out of state - or accept reconstruction they didn’t want.
“This senate law passing is exactly what I could have used in 2021,” Prather said.
“It would have allowed me to have less of a financial burden,” said San Nicolas. “I mean, at one point, we were relying on local food banks.”
“I would’ve saved a lot of personal time, effort, travel expenses,” added Daly.
The bill struck a chord with physicians too, who see firsthand how limited access affects their patients.
“I definitely have had patients settle for something that they didn’t want,” Dr. Dunham said. “It just helps so much so that people don’t feel like they’re stuck.”\
While Oregon is first to enact this law, advocates hope it won’t be the last.
“We’re not done, like this is only the beginning,” Menasco said.
Now, Menasco is headed to Washington, D.C. hoping to take the Oregon model nationwide.
The Oregon law takes effect at the New Year.
Link to article https://www.kptv.com/2025/10/15/oregon-becomes-first-state-guarantee-advanced-breast-reconstruction-coverage/