Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for c…
The bill requires group and individual health plans that cover diagnostic and supplemental breast examinations to eliminate cost-sharing (deductibles, coinsurance, copays) for those services. It defines diagnostic and supplemental examinations per NCCN guidelines, permits prior authorization and utilization controls, preserves stronger State laws, includes grandfathered plans, creates an HDHP/HSA safe harbor, and takes effect for plan years starting January 1, 2026.
Progressives emphasize access and early detection benefits
Relative to its intended legislative type, this bill is a focused substantive coverage mandate that is clearly drafted in statutory language, provides specific definitions, amends the relevant statutory and tax provisions, and sets an effective date, but it omits fiscal acknowledgment and detailed implementation or accountability mechanisms.
The bill requires group and individual health plans that cover diagnostic and supplemental breast examinations to eliminate cost-sharing (deductibles, coinsurance, copays) for those services.
It defines diagnostic and supplemental examinations per NCCN guidelines, permits prior authorization and utilization controls, preserves stronger State laws, includes grandfathered plans, creates an HDHP/HSA safe harbor, and takes effect for plan years starting January 1, 2026.
Technically narrow and non-controversial in subject, but imposes coverage mandate with budgetary effects and may face Senate procedural resistance.
Relative to its intended legislative type, this bill is a focused substantive coverage mandate that is clearly drafted in statutory language, provides specific definitions, amends the relevant statutory and tax provisions, and sets an effective date, but it omits fiscal acknowledgment and detailed implementation or accountability mechanisms.
Progressives emphasize access and early detection benefits
These are examples from the analysis, not a ranked list of the most-affected groups.
Progressives emphasize access and early detection benefits
This persona would likely strongly support the bill as a targeted measure to remove financial barriers to breast cancer diagnosis and screening for higher-risk people.
They would emphasize equity, earlier detection, and alignment with clinical guidelines.
They would note the HDHP safe harbor and protection for stronger State laws as positive technical fixes.
A pragmatic centrist would generally view the bill favorably because it reduces patient cost-sharing for clinically indicated tests while preserving utilization controls.
They would be cautious about fiscal and administrative consequences and want oversight on costs and implementation.
This persona would likely be skeptical or opposed, viewing the bill as a federal mandate that restricts private plan design and could raise costs.
They would appreciate preserved utilization controls and state-law protection, but remain concerned about mandates on employers and insurers.
Reached or meaningfully advanced
Reached or meaningfully advanced
Still ahead
Still ahead
Still ahead
Technically narrow and non-controversial in subject, but imposes coverage mandate with budgetary effects and may face Senate procedural resistance.
The bill has not accumulated any surfaced votes yet.
Progressives emphasize access and early detection benefits
Technically narrow and non-controversial in subject, but imposes coverage mandate with budgetary effects and may face Senate procedural res…
Relative to its intended legislative type, this bill is a focused substantive coverage mandate that is clearly drafted in statutory language, provides specific definitions, amends the relevant statutory and tax provisio…
Go beyond the headline summary with full stakeholder mapping, legislative design analysis, passage barriers, and lens-by-lens tradeoff breakdowns.