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S297119th CongressWALLET

PSA Screening for HIM Act

Sponsored By: Senator John Boozman

In Committee

Summary

This bill would require group and individual health plans to cover prostate cancer screening without cost-sharing for high-risk men aged 40 and older. It also expands coverage to other evidence-based preventive services for those men and spells out who counts as having a family history of prostate cancer.

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  • High-risk men and families: Men age 40 and over who are at high risk, including African-American men and those with a qualifying family history, would get prostate cancer screenings and related preventive care with no out-of-pocket costs.
  • Health plans and insurers: Group plans and individual insurers would have to provide this coverage for plan years beginning on or after January 1, 2025.
  • Clinical guidance: Coverage is tied to current U.S. Preventive Services Task Force recommendations, with a specific reference to recommendations issued around November 2009.
  • Definition of family history: The bill defines family history to include a first-degree relative diagnosed with or who died from prostate cancer, relatives with cancers linked to higher prostate cancer risk, or known genetic alterations associated with increased risk.

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Bill Overview

Analyzed Economic Effects

2 provisions identified: 2 benefits, 0 costs, 0 mixed.

More prostate screening for high-risk men

If enacted, group health plans and individual insurers would have to cover extra evidence-based prostate cancer screening and preventive services without cost-sharing for men age 40 and older who are at high risk. High risk includes African-American men and men with a first-degree relative who was diagnosed with prostate cancer, died from it, had a related cancer, or has a genetic change tied to higher risk. This change would apply to plan years beginning on or after January 1, 2025.

Clarify breast screening guideline status

If enacted, the bill would treat current USPSTF recommendations on breast cancer screening, mammography, and prevention as the "most current" for this law and other laws, except for recommendations issued around November 2009. Plans and issuers would still be allowed to cover services beyond or different from USPSTF advice. This rule would apply to plan years beginning on or after January 1, 2025.

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Sponsors & CoSponsors

Sponsor

John Boozman

AR • R

Cosponsors

  • Sen. Booker, Cory A. [D-NJ]

    NJ • D

    Sponsored 1/29/2025

  • Sen. Padilla, Alex [D-CA]

    CA • D

    Sponsored 2/25/2025

  • Raphael Warnock

    GA • D

    Sponsored 2/25/2025

  • Sen. Cantwell, Maria [D-WA]

    WA • D

    Sponsored 2/25/2025

  • Sen. Shaheen, Jeanne [D-NH]

    NH • D

    Sponsored 3/11/2025

  • Sen. Coons, Christopher A. [D-DE]

    DE • D

    Sponsored 3/12/2025

Roll Call Votes

No roll call votes available for this bill.

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