Alabama faces a critical healthcare access crisis.

In 2009 I was diagnosed with breast cancer. Treatment plan was lumpectomy/partial mastectomy. Almost 40 radiation treatments with medication for 5 years.

After treatment I did reconstructive surgery. My radiated side didn't heal well so my final results were horrible. But I was alive! After a few years, I consulted another plastic surgeon to see if we could make me a little more normal. He agreed, and again my radiated side didn't heal well. I ended up back in the hospital as an inpatient for a week, few more surgical procedures due to complications from not healing fast enough. I&D's, wound vac, pic line, home health, a month of hyperbarics and skin graft.

2024 — Breast cancer returns on same side. Treatment plan is a bilateral mastectomy with a Diep Flap procedure and another 5 years of medication. This was the best plan for me due to my past. This procedure would improve blood flow where blood vessels from my abdomen are reattached to help with faster healing. This is a no brainer.

My insurance at work has fought this every step of the way. (Keep in mind that I work at a hospital in one of the biggest medical chains in Mobile.) First they said I would have to travel "out of network" at my expense to have it done. My surgeon was doing this procedure at my place of employment. Then they said they were not paying for it at all. They said my surgeon was out of network even though I pay the more expensive plan to be able to choose doctors in and out of network. I was also told I could make a payment plan with my doctor. I said I already do! It's called monthly premiums. They are considering this as a cosmetic surgery because at the end of the day you have a "tummy tuck." The recovery for this is so much more than implants. I have just survived cancer and treatments twice. Why would I choose to go through this extensive procedure if it wasn't my best choice.

Insurance companies choose the quickest and easiest band aids. No thought for each individual situation.

Thank GOD we still have doctors and surgeons who are patient advocates and still believe in doing what is best for each patient instead of bowing to insurance companies.

My name is Candace Lovelace and I was first diagnosed with breast cancer in March of 2017. I was standing in the middle of a Toys R Us with my two little boys. There was no time for tears or a breakdown… that would come later. I was a healthy 37yo mom who just went in for a baseline mammogram at my doctor's advice. I was diagnosed with DCIS… it was early, no rush and I had options. We prayed and I chose to proceed with a mastectomy and a breast implant. This plan would be the fastest way to get me back to being the mom that my boys who were 5 and 7 needed. For five years I had tests every six months — mammograms, MRIs, ultrasounds — and I took Tamoxifen everyday. Those five years were not without fear or anxiety but they were without cancer.

On September 3, 2024 I went in for another routine mammogram. That day would not be routine. After being told that the mammogram was not "normal" things moved very quickly. An ultrasound, a biopsy and another biopsy… lots of tears. Two days later, I got another phone call. This diagnosis was new… more aggressive… spread to a lymph node… lots of tests. I had an MRI, a bone scan, a CT scan, a port placement, a biopsy, an ECHO, and chemo education all within three weeks.

Cancer has altered my life in every imaginable way… physically, emotionally and mentally. At one of those early visits Nate and I met with my surgical oncologist. In that visit I decided to take back some of that control. I simply said "I don't want another implant." For 6 years I had lived with a foreign object in my body. For 6 years I watched that implant slowly move down from its original position. For 6 years I looked in the mirror and saw two vastly different breasts.

Thankfully my surgeon had a solution that is actually best practice for my situation… a DIEP flap reconstruction. I could have breasts made from my own tissue. I was elated! I could be whole again! And it could happen here at home. I wouldn't have to leave my kids.

One year and 6 weeks after the first diagnosis, Nate and I arrived that morning at 5:30. As soon as my name was called I was met with a single sheet of paper and the instruction "I need you to sign this. Your provider is out of network and you have to sign this before surgery." No other explanation given. I read the form… my physician was advising me that I may have to pay for services IN FULL. I was confused, a little upset, and scared. Thankfully my husband looked at me and said this is what we are doing and we are doing it today. So I signed. When you are in the trenches of cancer and treatment sometimes all you can do is trust — trust your doctors who have taken a literal oath to do no harm, and trust that the insurance we have so faithfully paid for throughout our 25 years of marriage will come through for us in our time of need.

My name is Dianco Williams, and I am a breast cancer survivor.

When I was diagnosed with breast cancer, my primary focus was survival. Like so many women, I wanted to live. I wanted to be present for my children, my family, and my future. What I did not anticipate was that after enduring cancer, I would face another fight — this time with my insurance company — over how I would be allowed to heal.

From the very beginning, I was informed. My breast surgeon, Dr. Lindsey Beakley, carefully explained all of my reconstruction options. After reviewing my options, I knew the DIEP flap reconstruction would be the best choice for me. Over the years, I have learned that foreign objects in my body have never been a good option for me. This was not an emotional or rushed decision. It was an informed, thoughtful choice made with my physician.

When I met Dr. Mark Stalder, I felt hope. I met with him multiple times. I trusted him. I was confident in my care plan. That is when the interference began.

I received a phone call that my insurance company assigned me a representative to help navigate the process. This person identified themselves as my "personal representative" and immediately informed me that my doctor was not in network. That call made me deeply uncomfortable. My decision had already been made based on medical guidance — not insurance convenience.

Then, just a few days before my scheduled surgery, I received a call from the hospital. I was told that while the hospital itself was covered, my surgeon was not. I was encouraged — days before surgery — to consider calling another doctor who was in network. So I have to ask: why now? Why, at one of the most vulnerable moments of my life, was I being pressured to abandon a doctor I trusted, a plan I understood, and a reconstruction surgery that was the best path for me.

This experience made it painfully clear that insurance companies are not simply paying claims — they are influencing care. Reconstruction is not cosmetic. It is part of cancer treatment. It is part of healing — physically, emotionally, and mentally.

Dr. Stalder did my surgery knowing that he may not get paid. I had no idea. Because my doctor has a heart for his patients I was able to receive what was best for my body. This issue goes far beyond my personal story. It affects women across Alabama and beyond. This is a bipartisan issue. This is a women's health issue. This is a patient rights issue.

I am a breast cancer survivor. I was diagnosed in 2023, and while my cancer was caught very early, it was an aggressive type with a high chance of recurrence. It was found on my regular checkup — it could not be felt on exam. Because of that risk, I chose to have a double mastectomy. I knew in my heart that I did not want to face cancer more than once, and this decision gave me peace moving forward.

I deeply respect those who choose to remain flat and feel whole and confident in that choice. For me, however, being flat does not align with how I see myself. Reconstruction was an important part of my healing and my sense of self. It wasn't about vanity; it was about feeling like me again.

I met with multiple doctors and ultimately decided that a DIEP flap reconstruction was the best choice for me. I was disappointed to learn that no doctors in my area offered this procedure — not because it was new, but because it was not reliably reimbursed by insurance, which meant physicians were reluctant or unable to provide it.

I ended up having surgery in New Orleans at The Center for Restorative Breast. This was considered out of network, even though I had excellent coverage and there was not a doctor in my area that offered the surgery. I applied for an out-of-network exception. My doctors' office attempted to obtain an exemption from Blue Cross Blue Shield of Alabama, and I personally called repeatedly to request an urgent review. Despite those efforts, I received no determination for weeks. Just days before my scheduled surgery, a representative informed me that if I proceeded before a decision was made, the procedure would not be covered.

This was devastating. I had done everything asked of me. At the same time, I was facing the very real risk that delaying surgery could allow the cancer to spread to my lymph nodes. Waiting was not a safe option. With only two days' notice, we were forced to find a way to pay for a portion of the surgery ourselves. In 2023 alone, we spent over $30,000 on medical expenses. To do so, we depleted our savings and sold personal assets in order to move forward with treatment.

Patients deserve the ability to make informed decisions about their own bodies. Those decisions should not be dictated by insurance coverage or geographic availability. All forms of breast reconstruction should be accessible to patients — and those options should be available here in Alabama. Medical decisions should be made between patients and their doctors, not insurance companies. Patients deserve options, patients deserve timely decisions, and patients deserve dignity.