Congress removes cost barriers to breast cancer screening and diagnosis

What it does

This bill requires health insurance plans (both group and individual) to cover diagnostic and supplemental breast examinations with zero out-of-pocket costs to patients—no copays, deductibles, or coinsurance. It defines these exams as medically necessary breast imaging (mammography, MRI, ultrasound) used either to evaluate suspected abnormalities or to screen high-risk individuals, and it takes effect for plan years beginning January 1, 2026.

Why we flagged it

The bill's operative mechanism is a straightforward insurance mandate: it requires plans to cover specific diagnostic services without cost-sharing. This is a public-health measure designed to remove financial barriers to breast cancer detection.

What the text implies

• Insurers may respond by raising premiums across the board to offset the cost of free breast exams, shifting the burden from point-of-care to all enrollees.
• The bill's carve-out for high-deductible health savings account (HSA) plans (Section 223(c)(2)) allows those plans to maintain a deductible for other services while exempting breast exams, potentially creating administrative complexity.
• The definition of 'supplemental breast examination' tied to National Comprehensive Cancer Network Guidelines means coverage scope depends on evolving clinical standards, not fixed statutory language.
• Prior authorization and utilization controls remain permitted, so insurers retain gatekeeping power over which exams are deemed 'medically necessary and appropriate.'

Section numbers refer to the bill text the analysis read — linked under Primary records below.

Who it affects

Patients gain access to breast cancer diagnostic and supplemental screening without cost barriers, removing a financial obstacle to early detection. The cost is borne by insurers and ultimately distributed across the insured population via premiums, not concentrated on individual patients at the point of care.

Who stands to gain

• patients requiring breast cancer screening and diagnosis
• diagnostic imaging providers (radiology centers, hospitals offering mammography/MRI/ultrasound)

Named in the bill

group health plans, health insurance issuers, National Comprehensive Cancer Network (NCCN), high deductible health plans (HDHPs), health savings accounts (HSAs), Patient Protection and Affordable Care Act (ACA), Internal Revenue Code Section 223

Where it stands

12 cosponsors: 9 Democrats, 3 Republicans.

• Apr 28, 2025 — Introduced · Congress.gov: “Introduced in Senate”
• Apr 28, 2025 — Referred to Senate Committee on Health, Education, Labor, and Pensions · Congress.gov: “Read twice and referred to the Committee on Health, Education, Labor, and Pensions”

Dates and quoted wording are Congress.gov's action record; the timeline shows status changes, not every procedural step.

Money around this bill

7 lobbying clients named this bill on 10 disclosure filings across 2 quarters, Dec 2025 to Jun 2026. Those filings disclosed $6,100,000 in lobbying spend. A filing names 26 bills on average, so that figure is what each filing reported, not a share belonging to this bill.

More lobbying clients named this bill than 86% of bills with at least one filing.

Jeanne Shaheen, the sponsor, reported $-12,050 in PAC receipts in the 2026 cycle. $1,000 of that came from 1 PAC tied to these lobbying clients.

• American Cancer Society Cancer Action Network Inc — $3,620,000 on 2 filings
• Novartis — $1,410,000 on 1 filing
• GE Healthcare Technologies Inc. — $730,000 on 2 filings
• The Susan G. Komen Breast Cancer Foundation, Inc. Dba Susan G. Komen — $130,000 on 1 filing
• Hadassah, the Women's Zionist Organization of America, Inc. — $120,000 on 2 filings

Lobbying Disclosure Act filings through Jul 21, 2026. A filing shows who paid to lobby on a bill it names, not what changed.