Under Section 2713 of the Affordable Care Act, patients can get initial screening exams or tests without cost sharing for breast-, cervical, and colon-cancer screening, meaning they do not need to pay out of pocket for the exam or test. But often, the first free test or exam shows a need for further tests and navigation services for patients who need guidance in accessing the necessary follow-up care, as the Tradeoffs Podcast reported in 2022. Often, those follow-up tests can be numerous and costly, leading to what’s known informally as cancer-screening purgatory, the Tradeoffs report added.
Since the report was published, advocates for free cancer-screening follow-up care have been making progress on reducing or eliminating costs for follow-up testing for breast, cervical and colon-cancer, as the Value Based Insurance Design Center reported in August 2025.