Congress mandates free breast cancer screening for all insured women
H.R. 3037 — Access to Breast Cancer Diagnosis Act of 2025 · Filed by Debbie Dingell (D-MI) · 57 cosponsors · Introduced Apr 28, 2025 · Referred to committee
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What it does
This bill requires all health insurance plans to cover diagnostic and supplemental breast examinations with zero out-of-pocket costs (no copays, deductibles, or coinsurance) starting January 1, 2026. Diagnostic exams evaluate suspected abnormalities; supplemental exams screen high-risk individuals. Plans can still require prior authorization but cannot charge patients for these services.
Why we flagged it
The bill is a straightforward preventive health mandate requiring no-cost-sharing coverage for breast cancer diagnostic and supplemental imaging. It follows the established ACA framework of mandating preventive services without patient cost barriers.
What the text implies
- Insurers may respond by tightening prior authorization requirements or narrowing the definition of 'medically necessary' to manage costs, potentially creating administrative barriers that delay care despite zero copay.
- The bill ties coverage standards to National Comprehensive Cancer Network (NCCN) Guidelines, which are private-sector clinical standards; changes to NCCN guidance could shift coverage scope without legislative action.
The full analysis lists 4 implications of this text.
Who stands to gain
health insurance enrollees (especially women at elevated breast cancer risk); diagnostic imaging providers (radiology centers, hospitals offering mammography/MRI/ultrasound)