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119-hr-3037119th CongressWALLET

Access to Breast Cancer Diagnosis Act of 2025

Sponsored By: Representative Dingell, Debbie [D-MI-6]

Introduced

Summary

Would ban cost-sharing for diagnostic and supplemental breast examinations to reduce financial barriers to follow-up and risk-based imaging. This change would add a new Section 2730 to the Public Health Service Act and take effect for plan years starting January 1, 2026.

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  • People facing breast abnormalities or higher-than-average risk would not have to pay deductibles, coinsurance, copays, or out-of-pocket limits for medically necessary diagnostic or supplemental breast exams as defined by NCCN Guidelines. These exams include diagnostic mammography, breast MRI, and breast ultrasound.
  • Group health plans and individual market issuers must remove cost-sharing for these services but may still use timely prior authorization and other utilization controls. The law also preserves any state rules that give stronger coverage protections.
  • The bill protects high-deductible health plan status by adding a tax safe harbor so plans are not disqualified for lacking a deductible for these breast exams. The accommodation also applies to grandfathered plans.

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Bill Overview

Analyzed Economic Effects

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

No cost-sharing for breast exams

If passed, people in employer or individual health plans would not pay copays, coinsurance, or deductibles for diagnostic and supplemental breast exams. This would start for plan years beginning on January 1, 2026. Plans could still require timely prior authorization or other utilization controls for these exams. State laws that give stronger coverage would still apply. The bill would define these exams using National Comprehensive Cancer Network guidelines and list diagnostic mammography, breast MRI, and breast ultrasound as examples when medically necessary.

Keep HSA eligibility for breast exams

If passed, a plan would not lose high-deductible health plan status just because it waives the deductible for diagnostic or supplemental breast exams. This would preserve Health Savings Account eligibility for people in those plans. The change would apply to plan years beginning on January 1, 2026.

Sponsors & CoSponsors

Sponsor

Dingell, Debbie [D-MI-6]

MI • D

Cosponsors

  • Rep. McGovern, James P. [D-MA-2]

    MA • D

    Sponsored 10/5/2026

  • Rep. Beatty, Joyce [D-OH-3]

    OH • D

    Sponsored 10/6/2026

  • Rep. Fitzpatrick, Brian K. [R-PA-1]

    PA • R

    Sponsored 4/28/2025

  • Rep. Wasserman Schultz, Debbie [D-FL-25]

    FL • D

    Sponsored 4/28/2025

  • Rep. Doggett, Lloyd [D-TX-37]

    TX • D

    Sponsored 4/29/2025

  • Rep. Moore, Gwen [D-WI-4]

    WI • D

    Sponsored 6/6/2025

  • Del. Norton, Eleanor Holmes [D-DC-At Large]

    DC • D

    Sponsored 6/12/2025

  • Rep. Stansbury, Melanie A. [D-NM-1]

    NM • D

    Sponsored 6/20/2025

  • Rep. Moulton, Seth [D-MA-6]

    MA • D

    Sponsored 6/24/2025

  • Rep. Hayes, Jahana [D-CT-5]

    CT • D

    Sponsored 7/14/2025

  • Rep. Kennedy, Timothy M. [D-NY-26]

    NY • D

    Sponsored 7/23/2025

  • Rep. Larson, John B. [D-CT-1]

    CT • D

    Sponsored 8/12/2025

  • Rep. Tonko, Paul [D-NY-20]

    NY • D

    Sponsored 8/12/2025

  • Rep. Clarke, Yvette D. [D-NY-9]

    NY • D

    Sponsored 8/12/2025

  • Rep. McClellan, Jennifer L. [D-VA-4]

    VA • D

    Sponsored 8/12/2025

  • Rep. Lawler, Michael [R-NY-17]

    NY • R

    Sponsored 8/22/2025

  • Rep. Craig, Angie [D-MN-2]

    MN • D

    Sponsored 8/22/2025

  • Rep. Bresnahan, Robert P. [R-PA-8]

    PA • R

    Sponsored 10/3/2025

  • Rep. Kelly, Robin L. [D-IL-2]

    IL • D

    Sponsored 10/3/2025

  • Rep. Kean, Thomas H. [R-NJ-7]

    NJ • R

    Sponsored 10/3/2025

  • Rep. Peters, Scott H. [D-CA-50]

    CA • D

    Sponsored 10/3/2025

  • Rep. Landsman, Greg [D-OH-1]

    OH • D

    Sponsored 10/3/2025

  • Rep. Carter, Troy A. [D-LA-2]

    LA • D

    Sponsored 9/24/2026

  • Rep. Riley, Josh [D-NY-19]

    NY • D

    Sponsored 10/29/2026

  • Rep. Brownley, Julia [D-CA-26]

    CA • D

    Sponsored 10/29/2026

  • Rep. Tlaib, Rashida [D-MI-12]

    MI • D

    Sponsored 10/21/2025

  • Rep. Van Duyne, Beth [R-TX-24]

    TX • R

    Sponsored 10/21/2025

  • Rep. Lynch, Stephen F. [D-MA-8]

    MA • D

    Sponsored 10/24/2025

  • Rep. Pocan, Mark [D-WI-2]

    WI • D

    Sponsored 11/4/2025

  • Rep. McBath, Lucy [D-GA-6]

    GA • D

    Sponsored 11/7/2025

  • Rep. Tenney, Claudia [R-NY-24]

    NY • R

    Sponsored 11/7/2025

  • Rep. Gottheimer, Josh [D-NJ-5]

    NJ • D

    Sponsored 11/7/2025

  • Rep. Kim, Young [R-CA-40]

    CA • R

    Sponsored 11/7/2025

  • Rep. Neguse, Joe [D-CO-2]

    CO • D

    Sponsored 1/12/2026

  • Rep. Trahan, Lori [D-MA-3]

    MA • D

    Sponsored 1/12/2026

  • Rep. Elfreth, Sarah [D-MD-3]

    MD • D

    Sponsored 3/24/2026

  • Rep. Barragán, Nanette Diaz [D-CA-44]

    CA • D

    Sponsored 3/26/2026

  • Rep. Raskin, Jamie [D-MD-8]

    MD • D

    Sponsored 4/13/2026

  • Rep. Schrier, Kim [D-WA-8]

    WA • D

    Sponsored 4/27/2026

  • Rep. LaLota, Nick [R-NY-1]

    NY • R

    Sponsored 4/28/2026

  • Rep. Pingree, Chellie [D-ME-1]

    ME • D

    Sponsored 4/28/2026

  • Rep. Morelle, Joseph D. [D-NY-25]

    NY • D

    Sponsored 4/28/2026

  • Rep. Johnson, Julie [D-TX-32]

    TX • D

    Sponsored 5/11/2026

  • Rep. Miller, Max L. [R-OH-7]

    OH • R

    Sponsored 5/11/2026

  • Rep. Goldman, Daniel S. [D-NY-10]

    NY • D

    Sponsored 6/2/2026

  • Rep. Davis, Donald G. [D-NC-1]

    NC • D

    Sponsored 6/2/2026

  • Rep. Ross, Deborah K. [D-NC-2]

    NC • D

    Sponsored 6/15/2026

  • Rep. Houlahan, Chrissy [D-PA-6]

    PA • D

    Sponsored 6/15/2026

  • Rep. Van Drew, Jefferson [R-NJ-2]

    NJ • R

    Sponsored 6/15/2026

  • Rep. Stevens, Haley M. [D-MI-11]

    MI • D

    Sponsored 6/24/2026

  • Rep. Leger Fernandez, Teresa [D-NM-3]

    NM • D

    Sponsored 6/25/2026

  • Rep. Wilson, Joe [R-SC-2]

    SC • R

    Sponsored 6/29/2026

  • Rep. Bacon, Don [R-NE-2]

    NE • R

    Sponsored 6/29/2026

  • Rep. Bynum, Janelle S. [D-OR-5]

    OR • D

    Sponsored 8/17/2026

  • Rep. Grijalva, Adelita S. [D-AZ-7]

    AZ • D

    Sponsored 8/17/2026

  • Rep. Goodlander, Maggie [D-NH-2]

    NH • D

    Sponsored 8/24/2026

  • Rep. Thanedar, Shri [D-MI-13]

    MI • D

    Sponsored 8/24/2026

  • Rep. Lieu, Ted [D-CA-36]

    CA • D

    Sponsored 8/27/2026

  • Rep. Langworthy, Nicholas A. [R-NY-23]

    NY • R

    Sponsored 8/27/2026

  • Rep. Walkinshaw, James R. [D-VA-11]

    VA • D

    Sponsored 8/31/2026

  • Rep. Edwards, Chuck [R-NC-11]

    NC • R

    Sponsored 8/31/2026

  • Rep. Dean, Madeleine [D-PA-4]

    PA • D

    Sponsored 8/31/2026

  • Rep. Van Orden, Derrick [R-WI-3]

    WI • R

    Sponsored 9/2/2026

  • Rep. Vindman, Eugene Simon [D-VA-7]

    VA • D

    Sponsored 9/2/2026

  • Rep. Mackenzie, Ryan [R-PA-7]

    PA • R

    Sponsored 9/10/2026

  • Rep. Bell, Wesley [D-MO-1]

    MO • D

    Sponsored 9/10/2026

  • Rep. Smith, Adam [D-WA-9]

    WA • D

    Sponsored 9/10/2026

Roll Call Votes

No roll call votes available for this bill.

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