Access to Breast Cancer Diagnosis Act of 2025
Sponsored By: Representative Dingell, Debbie [D-MI-6]
Introduced
Summary
No cost-sharing for diagnostic and supplemental breast examinations under group and individual health plans. It would also preserve high-deductible health plan status when plans waive a deductible for those exams, starting with plan years beginning January 1, 2026.
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- Families and patients: Medically necessary diagnostic exams (like diagnostic mammography, breast MRI, and breast ultrasound) and supplemental exams based on personal or family risk would have no deductible, copay, coinsurance, or similar out-of-pocket charges.
- People in high-deductible health plans and Health Savings Account holders: A plan would not lose its high-deductible health plan status just because it does not apply a deductible to these breast exams for plan years beginning on or after January 1, 2026.
- Health plans and insurers: Plans may still require timely prior authorization and other appropriate utilization controls. The rule does not override any State law that offers greater protections.
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Bill Overview
Analyzed Economic Effects
2 provisions identified: 1 benefits, 0 costs, 1 mixed.
No-cost breast exams and HSA protection
If enacted, your group or individual plan would have to cover diagnostic and supplemental breast exams at $0 cost to you. These include diagnostic mammograms, breast MRI, or ultrasound when medically needed, and extra screening for people at higher risk. Plans could still require prior authorization or other use controls, and stronger state protections would still apply. High-deductible plans could waive the deductible for these exams and still keep HSA eligibility. This would start for plan years beginning on or after January 1, 2026.
Some grandfathered plans could lose status
This bill would treat the new $0 breast exam rule as a new ACA requirement for “grandfathered” plans. Some plans could lose grandfathered status, which may trigger other ACA rules. That could lead to changes in benefits or premiums for those enrollees. This would apply to plan years beginning on or after January 1, 2026.
Sponsors & CoSponsors
Sponsor
Dingell, Debbie [D-MI-6]
MI • D
Cosponsors
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
Stansbury
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
Kennedy (NY)
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
McClellan
VA • D
Sponsored 8/12/2025
Rep. Lawler, Michael [R-NY-17]
NY • R
Sponsored 8/22/2025
Craig
MN • D
Sponsored 8/22/2025
Bresnahan
PA • R
Sponsored 10/3/2025
Rep. Kelly, Robin L. [D-IL-2]
IL • D
Sponsored 10/3/2025
Kean
NJ • R
Sponsored 10/3/2025
Peters
CA • D
Sponsored 10/3/2025
Rep. Landsman, Greg [D-OH-1]
OH • D
Sponsored 10/3/2025
Rep. Tlaib, Rashida [D-MI-12]
MI • D
Sponsored 10/21/2025
Van Duyne
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
McBath
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
Trahan
MA • D
Sponsored 1/12/2026
Elfreth
MD • D
Sponsored 3/24/2026
Barragan
CA • D
Sponsored 3/26/2026
Rep. Raskin, Jamie [D-MD-8]
MD • D
Sponsored 4/13/2026
Schrier
WA • D
Sponsored 4/27/2026
LaLota
NY • R
Sponsored 4/28/2026
Pingree
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
Roll Call Votes
No roll call votes available for this bill.
View on Congress.gov