This bill would require group health plans and health insurance issuers that cover diagnostic and supplemental breast examinations to pay for those services without any cost-sharing. "Cost-sharing" in the bill means deductible, coinsurance, copayment, or similar out-of-pocket limits. The bill defines diagnostic and supplemental breast examinations using National Comprehensive Cancer Network guidelines and gives examples such as diagnostic mammography, breast magnetic resonance imaging (MRI), and breast ultrasound. Plans may still require timely prior authorization or other appropriate utilization controls. The bill also says state laws that give greater protections stay in effect. It amends rules for grandfathered plans and changes Internal Revenue Code rules so high-deductible health plans can remain eligible for health savings accounts even if they waive a deductible for these breast exams. The rule would apply to plan years beginning on or after January 1, 2026. The measure was introduced on April 28, 2025, and referred to the Senate Health, Education, Labor, and Pensions Committee. Sponsors are listed in the bill text.
No publicly available information on estimated federal or plan costs is included in the bill text. The bill does state that enrollees would not pay the listed forms of cost-sharing for covered diagnostic and supplemental breast exams.
No publicly available information on proponents' arguments or official statements is included in the bill text. The bill's sponsors introduced the measure as described above.
No publicly available information on opponents' arguments or official statements is included in the bill text.