Access to Breast Cancer Diagnosis Act of 2025
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Progress
Where this bill stands in the legislative process.
- Introduced
- Passed House
- Passed Senate
- To President
- Became Law
Overview
This bill, the Access to Breast Cancer Diagnosis Act of 2025, prohibits group health plans and health insurance issuers from requiring cost-sharing, such as deductibles or copays, for diagnostic and supplemental breast examinations. It ensures that these screenings and examinations are covered without out-of-pocket expenses for individuals enrolled in these plans. The bill also includes provisions to extend these protections to grandfathered health plans and high-deductible health plans with health savings accounts.
Key provisions
- Prohibits cost-sharing (deductibles, coinsurance, copays) for diagnostic and supplemental breast examinations.
- Defines ‘diagnostic breast examination’ as an examination to evaluate abnormalities found during screening or other examinations.
- Defines ‘supplemental breast examination’ as a screening examination for individuals with risk factors or based on family history.
- Extends coverage to grandfathered health plans.
- Includes a safe harbor for high-deductible health plans, preventing them from being considered non-high-deductible due to the absence of a deductible for these screenings.
- Applies the provisions starting January 1, 2026.
Who is affected
- Individuals enrolled in group health plans and health insurance coverage.
- Group health plans and health insurance issuers.
- Healthcare providers offering diagnostic and supplemental breast examinations.
Bill text
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Sponsors
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