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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 consideration of such provisions as fall within the jurisdiction of the committee concerned.
2026-04-28
Source: Congress.gov
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The proposal would require Medicare, Medicaid, and private health insurance plans to cover annual mammogram screenings for women starting at age 30 with no out-of-pocket costs to patients. Currently, most insurance plans only cover routine mammograms for women starting at age 40 or 50, so this would expand access to earlier breast cancer screening. The change would affect millions of women and their insurance providers across the country.
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[Congressional Bills 119th Congress] [From the U.S. Government Publishing Office] [H.R. 8551 Introduced in House (IH)] <DOC> 119th CONGRESS 2d Session H. R. 8551 To amend titles XVIII and XIX of the Social Security Act and title XXVII of the Public Health Service Act to provide no-cost coverage for annual screening mammography beginning at 30 years of age. _______________________________________________________________________ IN THE HOUSE OF REPRESENTATIVES April 28, 2026 Mr. Lawler introduced the following bill; which was 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 consideration of such provisions as fall within the jurisdiction of the committee concerned _______________________________________________________________________ A BILL To amend titles XVIII and XIX of the Social Security Act and title XXVII of the Public Health Service Act to provide no-cost coverage for annual screening mammography beginning at 30 years of age. Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled, SECTION 1. SHORT TITLE. This Act may be cited as the ``Early Access to Screening Act''. SEC. 2. NO-COST COVERAGE OF ANNUAL SCREENING MAMMOGRAPHY BEGINNING AT 30 YEARS OF AGE. (a) Coverage Under Medicare.-- (1) In general.--Section 1834(c) of the Social Security Act (42 U.S.C. 1395m(c)) is amended-- (A) in paragraph (1)(A), by inserting ``or (3)'' after ``paragraph (2)''; (B) in paragraph (2)-- (i) by striking the paragraph heading and inserting ``Frequency covered before january 1, 2026''; and (ii) in subparagraph (A), by striking ``Subject'' and inserting ``With respect to screening mammography performed before January 1, 2026, subject''; and (C) by adding at the end the following new paragraph: ``(3) Frequency covered on or after january 1, 2026.--With respect to screening mammography performed on or after January 1, 2026-- ``(A) no payment may be made under this part for screening mammography performed on a woman under 30 years of age; and ``(B) in the case of a woman over 29 years of age, payment may not be made under this part for screening mammography performed within 11 months following the month in which a previous screening mammography was performed.''. (2) Prohibition of cost sharing.--Section 1833(a)(1) of the Social Security Act (42 U.S.C. 1395l(a)(1)) is amended-- (A) in subparagraph (Y), by inserting ``(other than screening mammography (as defined in section 1861(jj)) performed on or after January 1, 2026)'' after ``in the case of such services described in subparagraph (A)''; (B) in subparagraph (GG), by striking ``and'' at the end; and (C) by inserting ``, and (II) with respect to screening mammography (as defined in section 1861(jj)) performed on or after January 1, 2026, the amounts paid shall be shall be 100 percent of the lesser of the actual charge for the services or the amount determined under the fee schedule that applies to such services under this part'' before the semicolon at the end. (3) Conforming amendment.--Section 1862(a)(1)(F) is amended by striking ``section 1834(c)(2)'' and inserting ``section 1834(c)''. (b) Coverage Under Medicaid.-- (1) Mandatory coverage.-- (A) In general.--Section 1902(a)(10)(A) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)) is amended by inserting ``(13)(D),'' before ``(17),''. (B) Medically needy.--Section 1902(a)(10)(C)(iv) of the Social Security Act (42 U.S.C. 1396a(a)(10)(C)(iv)) is amended by inserting ``(13)(D),'' before ``and (17)''. (C) Alternative benefit plans.--Section 1937(b) of the Social Security Act (42 U.S.C. 1396u-7(b)) is amended by adding at the end the following new paragraph: ``(9) Annual screening mammography.--Notwithstanding the previous provisions of this section, a State may not provide for medical assistance through enrollment of an individual with benchmark coverage or…
benchmark-equivalent coverage under this section unless, beginning on January 1, 2026, for any individual over age 29, such coverage includes (and does not impose any deduction, cost sharing, or similar charge for) annual screening mammography described in section 1905(a)(13)(D).''. (2) Inclusion under diagnostic, screening, preventive, and rehabilitative services.--Section 1905(a)(13) of the Social Security Act (42 U.S.C. 1396d(a)(13)) is amended-- (A) in subparagraph (B), by striking ``and'' at the end; (B) in subparagraph (C), by adding ``and'' at the end; and (C) by adding at the end the following new subparagraph: ``(D) beginning January 1, 2026, for individuals over age 29, annual screening mammography;''. (3) Prohibition of cost sharing.-- (A) In general.--Section 1916 of the Social Security Act (42 U.S.C. 1396o) is amended-- (i) in subsection (a)(2)-- (I) in subparagraph (I), by striking ``or'' at the end; (II) in subparagraph (J), by striking ``; and'' at the end and inserting ``, or''; and (III) by adding at the end the following new subparagraph: ``(K) beginning January 1, 2026, annual screening mammography described in section 1905(a)(13)(D); and''; and (ii) in subsection (b)(2)-- (I) in subparagraph (I), by striking ``or'' at the end; (II) in subparagraph (J), by striking ``; and'' at the end and inserting ``, or''; and (III) by adding at the end the following new subparagraph: ``(K) beginning January 1, 2026, annual screening mammography described in section 1905(a)(13)(D); and''. (B) Application to alternative cost sharing.-- Section 1916A(b)(3)(B) of the Social Security Act (42 U.S.C. 1396o-1(b)(3)(B)) is amended by adding at the end the following new clause: ``(xv) Beginning January 1, 2026, annual screening mammography described in section 1905(a)(13)(D).''. (c) Coverage Under Group Health Plans and Group and Individual Health Insurance.-- (1) In general.--Section 2713(a) of the Public Health Service Act (42 U.S.C. 300gg-13(a)) is amended-- (A) in paragraph (2), by striking at the end ``and''; (B) in paragraph (3), by striking at the end the period and inserting ``; and''; and (C) in paragraph (4)-- (i) by striking at the end the period and inserting ``; and''; (ii) by striking ``women, such'' and inserting ``women-- ``(A) such''; and (iii) by adding at the end the following new subparagraph: ``(B) in the case of a woman over 29 years of age, annual mammography screening.''. (2) Effective date.--The amendments made by this subsection shall apply to plan years beginning on or after January 1, 2026. <all>
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